Presented by: Omri Zonenfeld MD
Carmel Medical Center

Introduction

Urinary stone composition has a critical role in determining stone formers follow-up and treatment plans. In this study, our aim was to evaluate changes in stone composition for fragment Vs. whole stone sent for analysis.

Materials

A prospective single-center study. All stones obtained during ureteroscopy or PCNL were sent for standard Fourier-transform infrared spectroscopy (FTIR) analysis at a single central lab. The study group was comprised of patients who had whole stones and fragments extracted. Fragments and whole stones were sent for analysis separately. The Control group was comprised of patients who had only fragments extracted that were then divided into 2 batches and sent separately for analysis. Clinical and operative data were collected to determine factors affecting the disparity in analysis results.     

Results

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There were 28 patients enrolled, 9 in the study group and 19 in the control group. The disparity in stone analysis was observed in 56% vs 5% (p=0.003) in the study and control groups respectively. Calcium oxalate monohydrate was the most common stone type and disparities were noted in uric acid, struvite, and calcium phosphate components. Only the number of stones treated and procedure performed (PCNL) had a significant impact on analysis disparity (p=0.002 & p=0.03 respectively). No effects were found for Age, gender BMI or HU.

Conclusion

All stones obtained per procedure should be sent for analysis, as whole stones Vs. fragments may impact the final stone analysis report.

Funding

None.

Lead Authors

Ilan B. Klein, MD
Carmel Medical Center

Co-Authors

Yuval Freifeld, MD
Carmel Medical Center

Rani Zreik Zreik, MD
Carmel Medical Center

Mahran Kabaha, MD
Carmel Medical Center

Israel Ben Zichry, MD
Carmel Medical Center

Gazi Fares, MD
Carmel Medical Center

Yoram Dekel, MD
Carmel Medical Center

Ilan B, Klein, MD
Carmel Medical Center