Does gender have any influence on RIRS outcomes? Data from the FLEXible ureteroscopy Outcomes Registry (FLEXOR)

You have accessJournal of UrologyCME1 Apr 2023MP35-06 DOES GENDER HAVE ANY INFLUENCE ON RIRS OUTCOMES? DATA FROM THE FLEXIBLE URETEROSCOPY OUTCOMES REGISTRY (FLEXOR) Singh Abhishek, Sanz Isabel, Gauhar Vineet, Somani Bhaskar, Tailly Thomas, Castellani Daniele, Traxer Olivier, Teoh Jeremy Yuen-Chun, Chew Ben Hall, Lay Keat William Ong, Ann Chu Chai, Bin Hamri Saeed, Shrestha Anil, Soehabali Boyke, Angerri Oriol, and Emiliani Esteban Singh AbhishekSingh Abhishek More articles by this author , Sanz IsabelSanz Isabel More articles by this author , Gauhar VineetGauhar Vineet More articles by this author , Somani BhaskarSomani Bhaskar More articles by this author , Tailly ThomasTailly Thomas More articles by this author , Castellani DanieleCastellani Daniele More articles by this author , Traxer OlivierTraxer Olivier More articles by this author , Teoh Jeremy Yuen-ChunTeoh Jeremy Yuen-Chun More articles by this author , Chew Ben HallChew Ben Hall More articles by this author , Lay Keat William OngLay Keat William Ong More articles by this author , Ann Chu ChaiAnn Chu Chai More articles by this author , Bin Hamri SaeedBin Hamri Saeed More articles by this author , Shrestha AnilShrestha Anil More articles by this author , Soehabali BoykeSoehabali Boyke More articles by this author , Angerri OriolAngerri Oriol More articles by this author , and Emiliani EstebanEmiliani Esteban More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003269.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: RIRS as a modality for renal stone management is safe, efficacious and well established for small or mid-sized stones. There have been many comparisons on lasers, scopes, accessories and even patient position and their role in RIRS surgery. As technology and technical expertise for RIRS improves there is no evidence if the gender has any influence on the aforementioned variables and on SFR and complication outcomes when performing RIRSIn this study as part of TOWER initiative our primary aim is to evaluate possibly for the first time the role that gender has in performing flexible ureteroscopy from a large series of patients. METHODS: This study retrospectively analyzed patients who underwent RIRS for renal stones from January 2018 to August 2021. Twenty centres with expert endourologist performing RIRS across the globe contributed to creating the “FLEXOR” registry of 6669 patients whose data were analyzed by dividing patients into two groups male and female. Evaluation included baseline characteristics of the patients, such as age, race and stone characteristics. We also registered perioperative findings, results and complications according to the Clavien Dindo classification. RESULTS: A total of 6669 patients were included, 4407 (66.1%) were male and 2262 (33.9%) were female. Stone location and mean stone size was comparable in both groups (10.24 mm in males and 10.17 mm in females). Females compared to male patients had lower pain at initial presentation but significant higher fever and positive urine culture rates (12% vs 8% and 37% vs 34% respectively). The results showed that females had a slight longer hospital stay (3.8 vs 3.5 d) p<0.001) and more residual fragments after the procedure (23.03% vs. 20.97 (p=0.032)). In addition, overall complications were also slightly but significantly higher in women, with a rate of 15.74% in females and 14% in males (p=0.042), at the expense of significant higher fever rates 6.9% vs 5.7% and a higher but not significant higher sepsis rate (1.46%. vs. 1.1%). A multivariate analysis showed that larger stone size, multiple and lower pole stones seem to have a negative impact in the incidence of residual factors and overall complications. CONCLUSIONS: Our real life Global study reflects that female gender may have a correlation with slight increased residual fragment and overall low grade complications. However, even symptomatic women at presentation with fever and positive cultures can safely be treated by RIRS with no increased rate of sepsis with appropriate care. Our global study reiterated that lower pole, multiple and large stone volumes will have a higher residual fragment incidence in immediate post-operative period and need to be followed up appropriately. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e470 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Singh Abhishek More articles by this author Sanz Isabel More articles by this author Gauhar Vineet More articles by this author Somani Bhaskar More articles by this author Tailly Thomas More articles by this author Castellani Daniele More articles by this author Traxer Olivier More articles by this author Teoh Jeremy Yuen-Chun More articles by this author Chew Ben Hall More articles by this author Lay Keat William Ong More articles by this author Ann Chu Chai More articles by this author Bin Hamri Saeed More articles by this author Shrestha Anil More articles by this author Soehabali Boyke More articles by this author Angerri Oriol More articles by this author Emiliani Esteban More articles by this author Expand All Advertisement PDF downloadLoading ...