Short Attention Span Summary
ROCKin Roller Coaster!
Patients have anecdotally reported passing kidney stones after riding a roller coaster. Who would feel like riding a roller coaster while passing a kidney stone? I can’t answer that…but obviously someone much tougher than me.
This is by far the most fascinating study design I have seen in a long time. They used a silicon renal pelvocalyceal/ureteral surgical model, complete with real urine and actual kidney stones of varying sizes, and took it in a backpack wedged between the two “investigators” at renal height on the Big Thunder Mountain Railroad at Disney World 60 times with varying locations on the roller coaster. They found that stones had a 17% chance of passage in the front of the coaster, but the results improved sitting in the back, with a 64% stone passage rate. Upper calyx stones passed the best.
Spoon Feed
It would be cheaper and more fun to facilitate stone passage by roller coaster riding than surgery. The authors are quite serious about this, although I’m not sure how practical it is in real life to recommend the roller-coaster-as-therapy option.
BTW, all you residents out there that need a research project – a little creativity and you could find yourself riding roller coasters for your project…just sayin’.
Abstract
J Am Osteopath Assoc. 2016 Oct 1;116(10):647-52. doi: 10.7556/jaoa.2016.128.
ABSTRACT
CONTEXT:
The identification and evaluation of activities capable of dislodging calyceal renal calculi require a patient surrogate or validated functional pyelocalyceal renal model.
OBJECTIVE:
To evaluate roller coaster facilitation of calyceal renal calculi passage using a functional pyelocalyceal renal model.
METHODS:
A previously described adult ureteroscopy and renoscopy simulator (Ideal Anatomic) was modified and remolded to function as a patient surrogate. Three renal calculi of different sizes from the patient who provided the original computed tomographic urograph on which the simulator was based were used. The renal calculi were suspended in urine in the model and taken for 20 rides on the Big Thunder Mountain Railroad roller coaster at Walt Disney World in Orlando, Florida. The roller coaster rides were analyzed using variables of renal calculi volume, calyceal location, model position on the roller coaster, and renal calculi passage.
RESULTS:
Sixty renal calculi rides were analyzed. Independent of renal calculi volume and calyceal location, front seating on the roller coaster resulted in a passage rate of 4 of 24. Independent of renal calculi volume and calyceal location, rear seating on the roller coaster resulted in a passage rate of 23 of 36. Independent of renal calculi volume in rear seating, calyceal location differed in passage rates, with an upper calyceal calculi passage rate of 100%; a middle calyceal passage rate of 55.6%; and a lower calyceal passage rate of 40.0%.
CONCLUSION:
The functional pyelocalyceal renal model serves as a functional patient surrogate to evaluate activities that facilitate calyceal renal calculi passage. The rear seating position on the roller coaster led to the most renal calculi passages.
PMID: 27669068 [PubMed – in process]
