A Multicenter Comparison of the Safety and Effectiveness of Ureteroscopic Laser Lithotripsy in Obese and Normal Weight Patients

Abstract Objective: Surgical treatment of kidney stones in an obese patient (body mass index [BMI] >30 kg/m2) remains challenging as shockwave lithotripsy may not be an option due to weight limitations. We sought to determine the effectiveness of ureteroscopic laser lithotripsy in obese patients compared to nonobese controls. Materials and Methods: Patients from 2004 to 2007 were retrospectively analyzed providing a group of 292 patients (163 obese, 76 overweight, 53 normal) who underwent ureteroscopic procedures for urolithiasis at four centers in the United States and Canada. Results: The percentage of obese patients requiring flexible ureteroscopy (URS) (79%) was higher than in the other groups (P<0.0001). Flexible URS was associated with a lower stone-free rate (SFR) on multivariate analysis (P=0.034). There was no difference in SFRs of patients who required a ureteral access sheath, basket extraction, or received a postoperative stent. Complication rates did not differ between groups. Conclusion: SFR...