Mp26-01 Prospective Observational Cohort Study Comparing Surgical Intervention Versus Observation for Nephrolithiasis and History of Urinary Tract Infections: An Interim Analysis From the Edge Consortium

You have accessJournal of UrologyStone Disease: Medical & Dietary Therapy (MP26)1 May 2024MP26-01 PROSPECTIVE OBSERVATIONAL COHORT STUDY COMPARING SURGICAL INTERVENTION VERSUS OBSERVATION FOR NEPHROLITHIASIS AND HISTORY OF URINARY TRACT INFECTIONS: AN INTERIM ANALYSIS FROM THE EDGE CONSORTIUM Connor M. Forbes, Karen L. Stern, Amy Reed, Gopal Narang, Jonathan Moore, Jonathan Berger, Jonathan Katz, Jamie Finegan, Nicole L. Miller, Seth K. Bechis, Roger L. Sur, and Ryan S. Hsi Connor M. ForbesConnor M. Forbes , Karen L. SternKaren L. Stern , Amy ReedAmy Reed , Gopal NarangGopal Narang , Jonathan MooreJonathan Moore , Jonathan BergerJonathan Berger , Jonathan KatzJonathan Katz , Jamie FineganJamie Finegan , Nicole L. MillerNicole L. Miller , Seth K. BechisSeth K. Bechis , Roger L. SurRoger L. Sur , and Ryan S. HsiRyan S. Hsi View All Author Informationhttps://doi.org/10.1097/01.JU.0001009408.66023.77.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Retrospective studies evaluating surgical intervention for nephrolithiasis in patients with recurrent urinary tract infections (UTIs) report that infections resolve in approximately half of individuals after stone removal. Therefore, we sought to perform a multi-center, observational, prospective study with a comparison group to evaluate whether surgical treatment of stones is associated with a reduced risk of UTIs in patients with recurrent infections. METHODS: From November 2020-23, patients with kidney stones and 3 symptomatic, culture-confirmed (100k CFU/mL) UTIs in the preceding 12 months, or 2 in 6 months, were prospectively recruited at 3 academic institutions (NCT#04495699). After shared-decision making, observation or surgical intervention of the stone(s) was performed. The primary outcome was the occurrence of UTI relapse between 30 days and 6 months after enrollment comparing those on observation versus surgical intervention for kidney stones. RESULTS: Among 82 patients recruited, 20 opted for observation of their stones and 62 opted for surgical intervention. Follow-up data at 6 months was available for 11 observation and 37 intervention patients, with the remainder lost to follow-up or having data maturing. In the intervention group, 70% received their surgery and in the observation group 18% crossed over to surgery. The intervention group in the intention-to-treat analysis was significantly more likely to be stone free at 6 months (59% vs 0%. p<0.001). At 6 months, 45% of patients in the observation group compared to 32% of patients in the intervention group experienced one or more UTIs (n=5 vs 12, p=0.5). CONCLUSIONS: For patients with recurrent UTIs, surgical intervention is not associated with a significantly decreased risk of UTI relapse by 6 months. While underpowered to detect smaller differences, our findings suggest that surgery may have less of an impact on recurrent UTIs for non-obstructing stones than previously reported. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e413 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Connor M. Forbes More articles by this author Karen L. Stern More articles by this author Amy Reed More articles by this author Gopal Narang More articles by this author Jonathan Moore More articles by this author Jonathan Berger More articles by this author Jonathan Katz More articles by this author Jamie Finegan More articles by this author Nicole L. Miller More articles by this author Seth K. Bechis More articles by this author Roger L. Sur More articles by this author Ryan S. Hsi More articles by this author Expand All Advertisement PDF downloadLoading ...