Urolithiasis occurrence is increasing in both adults and children in the United States, with nearly 1 in 11 adults having a stone at some time in their life. Unfortunately, stone occurrence in children also appears to have increased from 1% to 2% in the 1950s to 1970s to almost 10%.
Patients undergoing ureteroscopy while remaining on anticoagulant therapy may be at increased risk for bleeding complications, including significant bleeding events and unplanned returns to the operating room, according to a retrospective study
Results from bench studies favor a new open-faced stone retrieval device (Dakota, Boston Scientific) for having greater versatility, efficacy, and durability compared with a competing product, and the in vitro performance of the new instrument is consistent with early clinical experience, says Roger L. Sur, MD.
"Increasingly, urologists are faced with patients who cannot safely discontinue anticoagulation or antiplatelet medications, even in the face of an impending surgical procedure. This is a trend that is likely to continue into the foreseeable future," writes Brian R. Matlaga, MD, MPH.
Percutaneous nephrolithotomy in the presence of aspirin appears both effective and safe. In a retrospective review of almost 300 PCNL cases, postoperative hemorrhage was uncommon in patients who continued aspirin preoperatively, said Brandon Otto, MD, at the AUA annual meeting in San Diego.