Abstracts from the Abstracts from the Mid-Atlantic Section of the AUA 2021

MA-AUA 2021 Abstracts Moderated Poster Session 2: Stones/Infection/Pediatrics MP2-04 Use of Novel Software for Predicting Outcomes Following Percutaneous Nephrolithotomy: A Pilot Study A. Yang 1 , S. Sappal 2 , E. Lehman 1 , N. Streeper 2 , J. Raman 2 , J. Knoedler 2 1 Penn State University, Hershey, PA, USA; 2 Penn State Health, Hershey, PA, USA Introduction and Objective: Percutaneous nephrolithotomy (PCNL) is a surgical treatment option for large and complex intrarenal stones. Despite its high stone free rate, it also has a relatively high risk of complications. Quantitative Stone Analysis Software (qSAS) is a novel application that analyzes the three-dimensional characteristics of urinary stones in a semi- automatic fashion. It may serve as a tool to predict outcomes following PCNL. The purpose of this study is to determine if the enhanced characterization of stone burden, provided by the novel qSAS, correlates with potential complications following PCNL. Methods: We performed a retrospective review of 50 patients with nephrolithiasis who underwent PCNL at a single institution. qSAS was used to analyze stone characteristics based on preoperative Computed Tomography (CT) imaging. Patient electronic medical records were surveyed for complications, including the need for further surgical intervention, occurringwithin 60 days postoperatively. Wilcoxon Rank Sumand Chi Square tests were applied to determine statistical significance. Results: The mean number of stones per patient was 2.0 (IQR = 2.0), the mean diameter was 41.3 mm (IQR = 35.2 mm), and the mean stone volume was 3,086 mm3 (IQR = 2,919 mm 3 ). Patients who required second procedures had a higher number of stones, as calculated by qSAS (3.2 vs. 1.8, p = 0.022). Additionally, those with secondary procedures showed a trend towards greater diameter of the largest stone (34.8 mm vs. 67.2 mm; p = 0.071) and greater total stone volume (2,603.2 mm 3 vs. 5,017.2 mm 3 ; p = 0.083), which fell short of significance. Conclusions: Greater number of stones, as detected by qSAS, is positively correlated with the need for additional procedures following PCNL. Further prospective studies should investigate the utility of qSAS for improved patient selection and surgical planning for nephrolithiasis. Use of Mini sipIT Behavioral Intervention to Increase Fluid Intake in Patients with Kidney Stones J. Fairbourn 1 , J. Marks 1 , D. Conroy 2 , E. Thomaz 3 , N. Ram 4 , N. Streeper 1 1 Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA; 2 Penn State University, University Park, PA, USA; 3 University of Texas at Austin, Austin, TX, USA; 4 Stanford University, Stanford, CA, USA Introduction and Objective: Wearable technology is both increasingly prevalent and successfully improving a variety of health behaviors. We previously showed that digital health tools are capable of identifying a lapse in drinking behavior in real-time to promote fluid consumption. The purpose of this study was to determine the feasibility, acceptability and impact of a simplified intervention, specifically a context-sensitive reminder system that incorporates a connected water bottle, with kidney stone patients – a population that often has poor adherence to increasing fluid intake for prevention. Methods: Patients with a history of kidney stones and urine volume less than 2 liters/day were recruited to participate in a 1-month feasibility trial. Patients were given an H20Pal connected water bottle and received hourly text message reminders when they were not meeting fluid intake goals. Perceptions of drinking behavior, intervention acceptability and 24-hour urine volumes were obtained at baseline and after the 1-month mini sipIT intervention. Results: Analysis of data from the 13 of 19 participants who have completed the study to date (77% female, age = 48.5 ± 16.9 years), indicates that 24-hour urine volumes increased for 69% of participants (median 1640 mL, IQR 1300- 2380mL). Most participants perceived that mini sipIT helped them to increase their fluid intake (85%) and more participants perceived that their drinking behavior was automatic (baseline 23% vs. post-intervention 46%). However, six participants reported that carrying the water bottle was cumbersome. Conclusions: The preliminary results indicate that mini sipIT intervention is feasible and provides automated lapse-detection that improves fluid intake. Although patients found the intervention acceptable, reports that carrying the water bottle was cumbersome suggest use of multimodal intake monitoring systems. Digital health tools in combination with behavioral science may help to improve adherence to fluid intake recommendations for kidney stone prevention. MP2-03 13