The Role of Glycemic Control on Outcomes after Stone Surgery

Document Type

Conference Proceeding

Publication Date

9-1-2025

Publication Title

J Endourol

Abstract

Introduction and Objective: Diabetes Mellitus (DM) is a wellestablished risk factor for kidney stone disease (KSD). Poor glycemic control, assessed by Hemoglobin A1c (HbA1c) levels, have been shown to affect post-operative outcomes after urological surgery, such as prosthesis implantation, but its impact on stone surgery outcome is unknown. In this study, we aimed to evaluate the prognostic value of preoperative glycemic status on post-surgical complication rates after endourological stone procedures. Methods: Adult KSD patients undergoing surgical intervention at a large tertiary US health system from January 1st 2018 to December 31st 2023 were retrospectively identified. Any post-operative complications within 30 days of the procedure were identified. Logistic regressions were conducted to identify independent variables associated with outcomes, adjusting for confounding. Results: We identified 2, 362 KSD patients of whom 694 (29%) had a complication and 1, 323 (56%) had DM. On multivariable analysis, an increase in HbA1c of 1% was significantly associated with any post-operative complication (OR 1.1, 95% CI 1.05-1.21, p<0.001), specifically urinary tract infections (OR 1.1, 95% CI 1.00-1.21, p=0.048), sepsis (OR 1.21, 95% CI 1.07-1.37, p=0.003) and acute kidney injury (OR 1.2, 95% CI 1.07-1.29, p<0.001).Use of antibiotics on the day of surgery was also significantly associated with reduced complications. Conclusions: This is the first study to assess the role of glycemic control on post-operative complication rates after stone surgery. A higher preoperative HbA1c was an independent predictor of post-operative UTI, sepsis and AKI. These findings underscore the importance of preoperative glycemic control improvement to mitigate post-operative complications in KSD patients.

Volume

39

Issue

S3

First Page

e116

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