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Kidney Stone Surgery Comes With Risk

RM Kidney

If you have never had a kidney stone before, then you should consider yourself fortunate. However, if you haven’t, or don’t know what one is, a kidney stone is a hard, crystalline mineral material formed within the kidney or urinary tract.

Kidney stones are a common cause of blood in the urine (hematuria) and often severe pain in the abdomen, flank, or groin. Kidney stones are sometimes called renal calculi. And while very often the method of getting rid of a kidney stone is to let it pass naturally – which is incredibly painful, in case you wanted to know – or in severe cases surgery will often be suggested. However, a recent study suggests that the debris, residue, and bacteria left behind in a kidney stone surgery can prove quite harmful.

The findings, presented at the 44th Annual Conference of the Association for Professionals in Infection Control and Epidemiology (APIC), concluded that these failures may result in the use of dirty scopes.

“APIC is concerned that the techniques used in the field are insufficient, and that current methods in place are introducing more contamination with the reprocessing of each scope,” said Linda Greene, APIC president. “The results of this study are concerning and should prompt hospitals to ensure that proper cleaning verification and visual inspections are being performed.”

The research, conducted by Ofstead & Associates, Inc., is the latest of its kind to raise concerns about infections associated with endoscopic procedures, as outbreaks have been linked to contaminated duodenoscopes, gastroscopes, bronchoscopes, and cystoscopes.

“This study underscores the importance of consistently monitoring reprocessing outcomes to ensure ureteroscopes are sterile and safe for patient use,” said lead study author Cori Ofstead. “Sterilization failures were unexpected and are deeply concerning.”

This is how the study played out: Researchers sampled 16 ureteroscopes at two institutions after they were cleaned and sterilized with hydrogen peroxide gas.

They detected contamination on 100 percent of the scopes. Every scope exceeded the benchmark for protein, hemoglobin was found on 63 percent, and 44 percent had higher adenosine triphosphate (ATP) levels than anticipated. Visual inspections identified debris protruding into channels, oily deposits, and white foamy residue, an abnormality that researchers had never seen. Needless to say, this is a rather shocking finding, especially when we consider what our perception of a clean hospital is, let alone surgical tools. And while this is certainly a step in the right direction for patients with kidney stones, it will be interesting to see what other similar findings this research may have involving different surgeries and medical equipment.