More Kidney Stone Surgery, More Complications -- Especially For Women

More Kidney Stone Surgery, More Complications -- Especially For Women
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By Jeffrey Kopman

Just the thought of kidney stones could be enough to make grown men and women cringe. Fortunately, a minimally invasive kidney stone surgery has risen in popularity in recent years. Unfortunately, the procedure is linked to a rise in complications, according to a study done at the Henry Ford Hospital in Detroit.

Kidney stones cause more than 1 million people in the United States to visit a doctor each year. More than 300,000 people will have to go to the emergency room for kidney stones in 2013.

The disorder, a worst nightmare for some men, is far less common in women -- only 20 percent of kidney stone patients are female. But the rising use of the surgery, percutaneous nephrolithotomy (PCNL), was caused by a greater increase in the number of women getting the surgery, relative to the more modest increase in men.

Other kidney stone surgeries exist, but have not experiences the 47 percent increase in usage that PCNL has. Those surgeries include lithotripsy and ureteroscopy. Smaller kidney stones can also be passed natrually.

The Henry Ford Hospital study, published in the Journal of Urology, identified patients who only underwent PCNL from 1999 to 2009, using data from more than 1,000 hospitals in 44 states.

Researchers found that the number of men given the surgery increased from 3.0 to 3.63 per 100,000 patients. Women experienced an even greater increase, from 2.99 to 4.07 per 100,000.

But the study also showed the rate of complications for the surgery, including blood infections, increased from 12.2 percent to 15.6 percent.

"We discovered that while the rate of PCNL-related death is low and has remained so, incidence of blood infection and overall complications has increased," said Khurshid R. Ghani, M.D., of Henry Ford's Vattikuti Urology Institute, in a press release.

The surgery's rise in popularity, amongst high risk patients (determined by age and health), women, and others who had previously not been given the surgery, was attributed to higher rates of overall complications.

"We believe the broad use of this procedure, especially in older and sicker patients, may be the reason for these changes," said Dr. Ghani.

Patients are not expected to be denied PCNL surgery because of this study. Rather, the findings show that the surgery should be encouraged for most people, but used with caution for certain demographics.

"We have no problem with performing PCNL surgery on our patients," said Robert Thompson, Jr., MD, and Urology Specialist of Maryland at Mercy Medical Center. "In terms of complications, we have not had many."

Mercy Medical hasn't noticed more complications with older or sick patients either, according to Dr. Thompson.

"If it's a huge stone, we need to use PCNL surgery," said Thompson. "[But] if they are really old or really sick we could remove the whole kidney. You have to use common sense."

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