Contemporary Imaging Practice Patterns Following Ureteroscopy for Stone Disease
Mohamed Omar1, Hemant Chaparala1, Manoj Monga1
1Department of Urology, Glickman Urological and Kidney Institute , The Cleveland Clinic, Cleveland, Ohio.
Journal of Endourology
|May 13, 2015
Summary
About half of urologists performing ureteroscopy for kidney stones obtain routine postoperative imaging. Decisions are influenced by factors like residual stones, complications, and patient symptoms, not just routine practice.
Area of Science:
- Urology
- Medical Imaging
- Health Economics
Background:
- Post-ureteroscopy imaging for renal/ureteral calculi is debated.
- Optimizing healthcare costs and quality necessitates judicious use of diagnostic imaging.
- Minimizing resource utilization while maximizing patient outcomes is a key priority.
Purpose of the Study:
- To identify current post-ureteroscopy imaging practices among experienced urologists.
- To understand the factors influencing imaging decisions after ureteroscopy.
- To assess the need for standardized imaging guidelines.
Main Methods:
- A REDcap questionnaire was distributed to North American urologists.
- Survey included demographic data, clinical volume, and imaging preferences.
- Assessed influence of stone, anatomic, and procedure factors on imaging choices.
Main Results:
- 48% of 322 urologists obtained routine postoperative imaging (US, KUB, CT, IVP, KUB+US).
- Urologists avoiding routine imaging cited cost, radiation, and diagnostic inaccuracy concerns.
- Postoperative pain, fever, residual stones, ureteral perforation, and solitary kidney predicted imaging use.
Conclusions:
- Approximately 50% of urologists performing ureteroscopy obtain routine postoperative imaging.
- Imaging practices are guided by specific clinical indicators rather than a universal protocol.
- Further research may inform evidence-based guidelines for post-ureteroscopy imaging.
Related Concept Videos
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography
3.0K
IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
3.0K
01:22Imaging Studies VI: Voiding Cystourethrography and Cystography
4.1K
Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
4.1K
01:24Imaging Studies II: Ultrasonography
785
IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
785
01:25Urinary Tract Calculi VI: Surgical Management
901
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
901
01:28Imaging Studies I: Kidney, Ureter, and Bladder Studies
738
Kidney, Ureter, and Bladder (KUB) StudiesKidney, Ureter, and Bladder (KUB) studies are standard diagnostic imaging procedures used to assess the anatomy of the urinary system. They are commonly utilized for patients experiencing abdominal pain or urinary symptoms. By using a simple X-ray of the abdomen, KUB studies can reveal structural and pathological abnormalities within the kidneys, ureters, and bladder. These studies are particularly valuable in diagnosing kidney stones, urinary...
738
01:28Urologic Endoscopic Procedure: Cystoscopic Examination
5.9K
Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
5.9K