2115 A VALIDATED QUESTIONNAIRE STUDY COMPARING STENT-RELATED SYMPTOMS BETWEEN CONVENTIONAL JJ STENTS AND A NOVEL THERMO-EXPANDABLE SEGMENTAL URETERIC METAL STENT

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THE JOURNAL OF UROLOGY姞

Vol. 183, No. 4, Supplement, Wednesday, June 2, 2010

(96.7% vs 93.3%, p⬍0.8). The image quality and image noise were also comparable in the ASIR and FBP group (IQ: 3.9 vs 3.8, N 1.7 vs 2.3, p⫽0.1). The average radiation dose reduction achieved with ASIR was 49.9% (range ⫽ 23-81%) compared to FBP technique (ASIR: 5 ⫾ 1.69mSv, FBP: 10.1 ⫾ 3.8mSv, p⫽0.01). CONCLUSIONS: MDCT with ASIR has comparable diagnostic accuracy to standard MDCT with a significant reduction in ionizing radiation delivered to the patient. This technology has the potential to provide improvements in the care of stone patients by reducing exposure to radiation and the theoretical increased risk of radiation-induced malignancy. Source of Funding: None

2115 A VALIDATED QUESTIONNAIRE STUDY COMPARING STENTRELATED SYMPTOMS BETWEEN CONVENTIONAL JJ STENTS AND A NOVEL THERMO-EXPANDABLE SEGMENTAL URETERIC METAL STENT Dharmesh Patel*, Tamer El-Husseiny, Konstantinos Moraitis, Zafar Maan, Junaid Masood, Noor Buchholz, London, United Kingdom INTRODUCTION AND OBJECTIVES: JJ stents have revolutionized the minimally invasive management of malignant and benign ureteric strictures. However, JJ stents are associated with significant morbidity and reduced quality of life. More recently, a permanent thermo-expandable nickel-titanium alloy, segmental ureteric stent (MemokathTM PNN Medical, Denmark) was introduced. We compare symptoms and quality of life in patients with ureteric strictures treated with either JJ stents or Memokath stents. METHODS: Over a one year period, validated ureteral stent symptom questionnaires (USSQ) were sent to 70 consecutive patients 4 weeks after insertion of JJ or Memokath TM stents. During this period, a sub-group of patients underwent insertion of both stents and hence completed two questionnaires. The USSQ is a self-administered multidimensional measure designed to evaluate stent-related morbidity in 6 sections: urinary symptoms, body pain, general health, work performance, sexual matters, and additional problems. RESULTS: The patients’ response rate was 58.5%. Memokath stents were significantly better for the domains of stent related pain, urinary symptoms index and general health compared with JJ stents and also significantly outperformed the JJ stent group in terms of light and heavy activity. Patients opted clearly in favour of Memokath stents for future stent insertion (Table 1). CONCLUSIONS: Patients with Memokath stents have an improved QOL because stent related morbidity is significantly lower than conventional JJ stents. Also Memokath stents don’t require frequent exchanges and are more cost-effective. QOL measure Prospect of living with urinary symptoms

JJ stent

MMK stent

p-value

6.0

3.0

0.02

Urinary symptoms index

32.0

21.5

0.048

Pain

18

7

0.009

Light activities

2.0

1.0

0.02

Heavy activities

3.0

2.0

0.04

Source of Funding: None

2116 DEVELOPMENT OF A NEW METHOD FOR MEASURING SERUM OXALATE USING A TRIS(2,2ⴕ-BIPYRIDYL)RUTHENIUM(II) CHEMILUMINESCENCE ANALYSIS SYSTEM AND IMPORTANCE IN UROLITHIASIS PATIENTS Takahiro Yasui*, Atsushi Okada, Takahiro Kobayashi, Masahito Hirose, Kazunori Nakaoka, Kazumi Taguchi, Yasuhiro Fujii, Kazuhiro Niimi, Yasuhiko Hirose, Masayuki Usami, Syuzo Hamamoto, Yasunori Itoh, Nagoya, Japan; Yasuyuki Yamada, Yatomi, Japan; Keiichi Tozawa, Kenjiro Kohri, Nagoya, Japan INTRODUCTION AND OBJECTIVES: It is important to perform urinary and serum oxalate to evaluate pathogenesis and diagnosis in urolithiasis patients. The measurement of the serum oxalate is difficult, because serum oxalate density is much lower than that of urinary oxalate. Many procedures have been reported for the measurement of urinary oxalate including enzymatic assay, various chromatographies and capillary electrophoresis. We recently developed the method for measuring serum oxalate using a tris(2,2⬘-bipyridyl)ruthenium(II) chemiluminescence analysis system. METHODS: Specimens: Blood samples of 50 calcium oxalate urolithiasis patients (38 men, 12 women) and 6 healthy men and 1 primary hayperoxaluria patient. Measurement method: Blood specimens were centrifuged (for 2,000G⫻10min) after standing at room temperature to separate the serum. An equal amount deproteinization liquid was added to each sample, separated (for 5,000G⫻15min) and the supernatant corrected. The samples were reacted with tris(2,2⬘bipyridyl)ruthenium(II) complex and emission of light was measured with a light detector (FOM-110A, Hokuto, Yokohama, Japan). The detectable range in oxalate was from 0.2 to 10 ␮mol/l. We plotted a fixed-quantity straight line by measuring the control oxalate solution and samples diluted to 2, 4, 8 times and calculated the oxalate density of the specimens. RESULTS: It took only 20 minutes to prepare and measure each sample. The serum oxalate density was approximately constant at each dilution. The serum oxalate densities were 14.8⫾6.1␮mol/L (urolithiasis men), 13.5⫾5.7␮mol/L (urolithiasis women), and 4.8⫾1.5 ␮mol/L (healthy men). The serum oxalate density of the primary hyperoxauria patients was 80-90 ␮mol/L, but fell to about 40 ␮mol/L 2 months after liver and renal transplantation. CONCLUSIONS: We developed a measurement method for serum oxalate density. The analytical characteristics of these chemiluminescence substances have high sensitivity, wide detectable range, few contaminations problems and low background levels. In this study serum oxalate level in urolithiasis patients was higher level than that in healthy men. It was thought that the measurement of serum oxalate is useful not only as an index for treatment of primary hyperoxaluria patients but also in screening, evaluation of pathogenesis and prevention for calcium oxalate urolithiasis patients. Source of Funding: None

2117 EFFICACY OF NOVEL COAXIAL OCCLUSION DEVICE TO PREVENT STONE MIGRATION DURING PERCUTANEOUS NEPHROLITHOTOMY (PCNL) Matthew Wosnitzer*, Michael Rothberg, Hiroshi Katsumi, Mantu Gupta, New York, NY INTRODUCTION AND OBJECTIVES: PCNL is often preceded by placement of a ureteral catheter into the collecting system to perform retrograde pyelography (RPG), define pelvicalyceal anatomy, and distend the collecting system to facilitate percutaneous needle access. We tested the safety and efficacy of a new coaxial film-based 15 mm occlusion device, Coaxial Accordion™ (Percsys, Mountain View, CA) designed to facilitate RPG while simultaneously preventing stone migration during PCNL. METHODS: A retrospective review of our institutional PCNL database from January to October 2009 analyzed patient demograph-