Original articleAbdominal pelvic radiotherapy prolongs surgical time of retrograde endoscopic treatment of upper urinary tract stones
DOI:
https://doi.org/10.48193/0rvvj842Keywords:
urolithiasis, abdominal pelvic radiotherapy, retrograde ureteroscopyAbstract
Objective: the main objective is to assess whether urolithiasis diagnosed in patients with previous APRT need more endoscopic procedures to reach stone-free status and if these procedures are longer. The secondary objective is to find out if these patients have more complications resulting from endourologic procedures.
Design and methodology: we designed a case-control unicentric study including patients with upper urinary tract lithiasis treated with retrograde ureterorenoscopy (URS) between 2006 and 2022. Case patients have previous history of APRT, while controls are patients without this history. We collected epidemiological, lithiasis and treatment related information in both groups.
Results: we identified 18 upper urinary tract stones in cases that underwent endoscopic retrograde treatment. We linked these urinary stones with 18 urolithiasis diagnosed in control patients. The average age in patients and the diameter of the stones diagnosed were very similar in both groups, as well as the stones’ location. Longer surgical time was found for lithiasis treatment in case patients (129.6 versus 80.2 minutes in controls, p = 0.025). No significant differences were found regarding the rest of variables.
Limitations: this is a retrospective and observational study, and the sample size is small, so we need to expand to a multicentric study.
Originality and value: to our best knowledge this is the first study to provide data on how APRT may affect the effectiveness of endourological treatment of urolithiasis.
Conclusion: endourological procedures for treatment of upper urinary tract stones in patients with previous APRT are longer than in patients without this background.
References
Hubenak JR, Zhang Q, Branch CD, Kronowitz SJ. Mechanisms of injury to normal tissue after radiotherapy: a review. Plastic and Reconstructive Surgery. 2014;133(1): 49e–56e. https://doi.org/10.1097/01.prs.0000440818.23647.0b.
Farhood B, Khodamoradi E, Hoseini-Ghahfarokhi M, Motevaseli E, Mirtavoos-Mahyari H, Eleojo Musa A, et al. TGF-β in radiotherapy: Mechanisms of tumor resistance and normal tissues injury. Pharmacological Research. 2020;155: 104745. https://doi.org/10.1016/j.phrs.2020.104745.
Gianfaldoni S, Gianfaldoni R, Wollina U, Lotti J, Tchernev G, Lotti T. An Overview on Radiotherapy: From Its History to Its Current Applications in Dermatology. Open Access Macedonian Journal of Medical Sciences. 2017;5(4): 521–525. https://doi.org/10.3889/oamjms.2017.122.
Wei J, Wang B, Wang H, Meng L, Zhao Q, Li X, et al. Radiation-Induced Normal Tissue Damage: Oxidative Stress and Epigenetic Mechanisms. Oxidative Medicine and Cellular Longevity. 2019;2019: 3010342. https://doi.org/10.1155/2019/3010342.
Elliott SP, Malaeb BS. Long-term urinary adverse effects of pelvic radiotherapy. World Journal of Urology. 2011;29(1): 35–41. https://doi.org/10.1007/s00345-010-0603-x.
Handmer M, Martin J, Tiu A. Costing Urologic Complications Following Pelvic Radiation Therapy. Urology. 2020;140: 64–69. https://doi.org/10.1016/j.urology.2020.01.046.
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: a cancer journal for clinicians. 2021;71(3): 209–249. https://doi.org/10.3322/caac.21660.
Zwaans BMM, Krueger S, Bartolone SN, Chancellor MB, Marples B, Lamb LE. Modeling of chronic radiation-induced cystitis in mice. Advances in Radiation Oncology. 2016;1(4): 333–343. https://doi.org/10.1016/j.adro.2016.07.004.
David RV, Kahokehr AA, Lee J, Watson DI, Leung J, O’Callaghan ME. Incidence of genitourinary complications following radiation therapy for localised prostate cancer. World Journal of Urology. 2022;40(10): 2411–2422. https://doi.org/10.1007/s00345-022-04124-x.
Bosch R, McCloskey K, Bahl A, Arlandis S, Ockrim J, Weiss J, et al. Can radiation‐induced lower urinary tract disease be ameliorated in patients treated for pelvic organ cancer: ICI‐RS 2019? Neurourology and Urodynamics. 2020;39(Suppl 3): S148–S155. https://doi.org/10.1002/nau.24380.
Sindelar WF, Kinsella TJ. Normal tissue tolerance to intraoperative radiotherapy. Surgical Oncology Clinics of North America. 2003;12(4): 925–942. https://doi.org/10.1016/s1055-3207(03)00087-5.
Beller HL, Rapp DE, Zillioux J, Abdalla B, Duska LR, Showalter TN, et al. Urologic Complications Requiring Intervention Following High-dose Pelvic Radiation for Cervical Cancer. Urology. 2021;151: 107–112. https://doi.org/10.1016/j.urology.2020.09.011.
Goodman M, Dalton JR. Ureteral strictures following radiotherapy: incidence, etiology and treatment guidelines. The Journal of Urology. 1982;128(1): 21–24. https://doi.org/10.1016/s0022-5347(17)52732-9.
Simeone C, Tanello M, Rosini R, Botturi A, Tralce L, Sironi D, et al. ["Post-actinic pelvic disease" and the ureter: the post-actinic ureter]. Archivio Italiano Di Urologia, Andrologia: Organo Ufficiale [di] Societa Italiana Di Ecografia Urologica E Nefrologica. 2002;74(1): 12–15.
Chrouser KL, Leibovich BC, Sweat SD, Larson DW, Davis BJ, Tran NV, et al. Urinary fistulas following external radiation or permanent brachytherapy for the treatment of prostate cancer. The Journal of Urology. 2005;173(6): 1953–1957. https://doi.org/10.1097/01.ju.0000158041.77063.ff.
Mitterberger M, Frauscher F, Steppan I, Peschel R, Pinggera GM. Ureteroiliac fistula: a case report review of the literature. Cases Journal. 2009;2: 6266. https://doi.org/10.4076/1757-1626-2-6266.
Batter SJ, McGovern FJ, Cambria RP. Ureteroarterial fistula: case report and review of the literature. Urology. 1996;48(3): 481–489. https://doi.org/10.1016/S0090-4295(96)00202-6.
Tuite DJ, Ryan JM, Johnston C, Brophy DP, McEniff N. Case report: ureteroiliac fistula: a late sequela of radiotherapy and long-term ureteric stent placement. Clinical Radiology. 2006;61(6): 531–534. https://doi.org/10.1016/j.crad.2006.02.001.
Turo R, Hadome E, Somov P, Hamid B, Gulur DM, Pettersson BA, et al. Uretero-Arterial Fistula - Not So Rare? Current Urology. 2018;12(1): 54–56. https://doi.org/10.1159/000489419.
Toolin E, Pollack HM, McLean GK, Banner MP, Wein AJ. Ureteroarterial fistula: a case report. The Journal of Urology. 1984;132(3): 553–554. https://doi.org/10.1016/s0022-5347(17)49734-5.
Kelleher JP, Snell ME. Pelvic irradiation, the ureter and extracorporeal shockwave lithotripsy. British Journal of Urology. 1990;66(4): 437. https://doi.org/10.1111/j.1464-410x.1990.tb14977.x.
Ibrahim AK. Reporting ureteroscopy complications using the modified clavien classification system. Urology Annals. 2015;7(1): 53–57. https://doi.org/10.4103/0974-7796.148611.
Perez Castro E, Osther PJS, Jinga V, Razvi H, Stravodimos KG, Parikh K, et al. Differences in ureteroscopic stone treatment and outcomes for distal, mid-, proximal, or multiple ureteral locations: the Clinical Research Office of the Endourological Society ureteroscopy global study. European Urology. 2014;66(1): 102–109. https://doi.org/10.1016/j.eururo.2014.01.011.
Caballero Romeu JP, Galán Llopis JA. MicroURS ¿una técnica para quedarse? Archivos Españoles de Urología 2017; 134–140.
Caballero-Romeu JP, Galán-Llopis JA, Soria F, Morcillo-Martín E, Caballero-Pérez P, Garcia A, et al. Micro-ureteroscopy vs. ureteroscopy: effects of miniaturization on renal vascularization and intrapelvic pressure. World Journal of Urology. 2018;36(5): 811–817. https://doi.org/10.1007/s00345-018-2205-y.
Shahrour W, Joshi P, Hunter CB, Batra VS, Elmansy H, Surana S, et al. The Benefits of Using a Small Caliber Ureteroscope in Evaluation and Management of Urethral Stricture. Advances in Urology. 2018;2018: 9137892. https://doi.org/10.1155/2018/9137892.
Zeng GH, Li X, Wu KJ, Chen WZ. [Endoscopic management of bilateral ureteral obstruction after radiotherapy]. Ai Zheng = Aizheng = Chinese Journal of Cancer. 2004;23(1): 108–109.
Schoenthaler M, Buchholz N, Farin E, Ather H, Bach C, Bach T, et al. The Post-Ureteroscopic Lesion Scale (PULS): a multicenter video-based evaluation of inter-rater reliability. World Journal of Urology. 2014;32(4): 1033–1040. https://doi.org/10.1007/s00345-013-1185-1.
Darwish AE, Gadelmoula MM, Abdelkawi IF, Abdellatif AM, Abdel-Moneim AM, Hammouda HM. Ureteral stricture after ureteroscopy for stones: A prospective study for the incidence and risk factors. Urology Annals. 2019;11(3): 276–281. https://doi.org/10.4103/UA.UA_110_18.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Revista Mexicana de Urología

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.