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The Degree of Hydronephrosis as an Indicator of the Necessity for Ureteric Dilatation during Ureteroscopic Lithotripsy

During rigid ureteroscopic lithotripsy, it is often encountered that the ureter is difficult to access. Attempts to advance the ureteroscope make the surgery more difficult. This study evaluated the preoperative predictive factors associated with difficult ureteral access (difficult ureter (DU)) dur...

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Autores principales: Lee, Hyun-Soo, Jo, Seon-Beom, Hwang, Wonku, Kim, Jong-Wook, Oh, Mi-Mi, Park, Hong-Seok, Moon, Du-Geon, Ahn, Sun-Tae
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380207/
https://www.ncbi.nlm.nih.gov/pubmed/37510710
http://dx.doi.org/10.3390/jcm12144591
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author Lee, Hyun-Soo
Jo, Seon-Beom
Hwang, Wonku
Kim, Jong-Wook
Oh, Mi-Mi
Park, Hong-Seok
Moon, Du-Geon
Ahn, Sun-Tae
author_facet Lee, Hyun-Soo
Jo, Seon-Beom
Hwang, Wonku
Kim, Jong-Wook
Oh, Mi-Mi
Park, Hong-Seok
Moon, Du-Geon
Ahn, Sun-Tae
author_sort Lee, Hyun-Soo
collection PubMed
description During rigid ureteroscopic lithotripsy, it is often encountered that the ureter is difficult to access. Attempts to advance the ureteroscope make the surgery more difficult. This study evaluated the preoperative predictive factors associated with difficult ureteral access (difficult ureter (DU)) during URS and assessed if clinical outcomes differed according to the degree of DU. This study identified 217 patients who underwent rigid ureteroscopic (URS) lithotripsy for the management of ureter stones between June 2017 and July 2021 in a tertiary hospital in Korea. In this group, preoperative factors were identified using univariate and multiple logistic regression analyses that could predict the degree of DU. Additionally, we also evaluated differences in treatment outcomes depending on the degree of DU. In 50 URS cases (22.0%), ureteral access using a ureteroscope was difficult. In the univariate and multivariate analyses, the degree of hydronephrosis was associated with the degree of DU. Treatment outcomes, extended operation times, low stone-free rate, postoperative pain, and secondary treatment were also significantly associated with the degree of DU. Clinicians can counsel patients with a lesser degree of hydronephrosis and approach their management accordingly.
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spelling pubmed-103802072023-07-29 The Degree of Hydronephrosis as an Indicator of the Necessity for Ureteric Dilatation during Ureteroscopic Lithotripsy Lee, Hyun-Soo Jo, Seon-Beom Hwang, Wonku Kim, Jong-Wook Oh, Mi-Mi Park, Hong-Seok Moon, Du-Geon Ahn, Sun-Tae J Clin Med Article During rigid ureteroscopic lithotripsy, it is often encountered that the ureter is difficult to access. Attempts to advance the ureteroscope make the surgery more difficult. This study evaluated the preoperative predictive factors associated with difficult ureteral access (difficult ureter (DU)) during URS and assessed if clinical outcomes differed according to the degree of DU. This study identified 217 patients who underwent rigid ureteroscopic (URS) lithotripsy for the management of ureter stones between June 2017 and July 2021 in a tertiary hospital in Korea. In this group, preoperative factors were identified using univariate and multiple logistic regression analyses that could predict the degree of DU. Additionally, we also evaluated differences in treatment outcomes depending on the degree of DU. In 50 URS cases (22.0%), ureteral access using a ureteroscope was difficult. In the univariate and multivariate analyses, the degree of hydronephrosis was associated with the degree of DU. Treatment outcomes, extended operation times, low stone-free rate, postoperative pain, and secondary treatment were also significantly associated with the degree of DU. Clinicians can counsel patients with a lesser degree of hydronephrosis and approach their management accordingly. MDPI 2023-07-10 /pmc/articles/PMC10380207/ /pubmed/37510710 http://dx.doi.org/10.3390/jcm12144591 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lee, Hyun-Soo
Jo, Seon-Beom
Hwang, Wonku
Kim, Jong-Wook
Oh, Mi-Mi
Park, Hong-Seok
Moon, Du-Geon
Ahn, Sun-Tae
The Degree of Hydronephrosis as an Indicator of the Necessity for Ureteric Dilatation during Ureteroscopic Lithotripsy
title The Degree of Hydronephrosis as an Indicator of the Necessity for Ureteric Dilatation during Ureteroscopic Lithotripsy
title_full The Degree of Hydronephrosis as an Indicator of the Necessity for Ureteric Dilatation during Ureteroscopic Lithotripsy
title_fullStr The Degree of Hydronephrosis as an Indicator of the Necessity for Ureteric Dilatation during Ureteroscopic Lithotripsy
title_full_unstemmed The Degree of Hydronephrosis as an Indicator of the Necessity for Ureteric Dilatation during Ureteroscopic Lithotripsy
title_short The Degree of Hydronephrosis as an Indicator of the Necessity for Ureteric Dilatation during Ureteroscopic Lithotripsy
title_sort degree of hydronephrosis as an indicator of the necessity for ureteric dilatation during ureteroscopic lithotripsy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380207/
https://www.ncbi.nlm.nih.gov/pubmed/37510710
http://dx.doi.org/10.3390/jcm12144591
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