Outcomes and Long-term Follow-up of Patients with Cystine Stones: a Systematic Review
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Purpose of Review
Cystine stone patients can be difficult to manage with frequent recurrences. We performed a systematic review with a view to assessing interventions, compliance and their long-term outcomes.
Ten retrospective observational studies (253 patients) assessed the outcomes and long-term follow-up of cystine stone patients. The mean length of follow-up was 9.6 years (range 3.5–21.8 years). The overall mean number of surgical procedures/patient was 5.7 (range 2–9.8/patient) with the overall mean number of surgical procedures/patient/year at 0.59 (range 0.22–1.32/patient/year). While open surgery has decreased over the last decade and PCNL has been stable, there seems to be a rise of RIRS during this period.
Patients with cystine stones need periodic interventions for stone recurrences despite medical management, with limited data showing the impact on renal function. While the management is individualised, wide variability exists with often poor and incomplete patient data.
KeywordsUrolithiasis Cystinuria Cystine stone Kidney stone disease (KSD) Outcomes Recurrence Ureteroscopy PCNL
Compliance with Ethical Standards
Conflict of Interest
Sacha L Moore, Paul Cook, Vincent de Coninck, Etienne Xavier Keller, Olivier Traxer, Laurian Dragos, and Iqbal S Shergill each declare no potential conflicts of interest. Bhaskar K Somani is a section editor for Current Urology Reports.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 11.• Moore SL, Somani BK, Cook P. Journey of a cystinuric patient with a long-term follow-up from a medical stone clinic: necessity to be SaFER (stone and fragments entirely removed). Urolithiasis. 2018:1–6 This study provides much-needed up-to-date recurrence data and also attempts to evaluate the impact of cystinuria on renal function over time. Google Scholar
- 12.• Usawachintachit M, Sherer B, Hudnall M, Tzou DT, Taguchi K, Hsi RS, et al. Clinical outcomes for cystinuria patients with unilateral versus bilateral cystine stone disease. J Endourol. 2018;32(2):148–53 This study is the largest observational study of cystinuric patients published to date, with good follow-up length and detailed breakdown of types of surgical intervention. CrossRefGoogle Scholar