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Characteristics and outcomes of ureteroscopic treatment in 2650 patients with impacted ureteral stones.
- Source :
-
World journal of urology [World J Urol] 2017 Oct; Vol. 35 (10), pp. 1497-1506. Date of Electronic Publication: 2017 Mar 20. - Publication Year :
- 2017
-
Abstract
- Purpose: To describe stone-free rates and complications of ureteroscopic treatment for impacted compared with non-impacted ureteral stones and evaluate predictive variables for impaction.<br />Methods: The Clinical Research Office of the Endourological Society prospectively collected 1 consecutive year of data from 114 centers worldwide. Patients eligible for inclusion were patients treated with ureteroscopy for ureteral stones. Patient characteristics, treatment details, and outcomes were compared with regard to stone impaction. Logistic regression analyses were conducted to explore predictive variables for ureteral stone impaction and to analyse the effect of impaction on outcomes.<br />Results: Of the 8543 treated patients, 2650 (31%) had impacted and 5893 (69%) non-impacted stones. The stone-free rate was 87.1% for impacted stones, which is lower compared with 92.7% for non-impacted stones (p < 0.001). Intra-operative complication rates were higher for impacted stones (7.9 versus 3.0%, p < 0.001). Significantly higher ureteral perforation- and avulsion rates were reported in the impacted stone group compared with the non-impacted stone group. No association between stone impaction and post-operative complications could be shown. Female gender, ASA-score >1, prior stone treatment, positive pre-operative urine culture, and larger stones showed to be predictive variables for stone impaction.<br />Conclusions: Ureteroscopic treatment for impacted stones is associated with lower stone-free rates and higher intra-operative complication rates compared with treatment for non-impacted stones. The predictive variables for the presence of stone impaction may contribute to the identification of stone impaction during the diagnostic process. Moreover, identification of stone impaction may aid the selection of the optimal treatment modality.
- Subjects :
- Adult
Female
Humans
Male
Middle Aged
Patient Selection
Prospective Studies
Risk Adjustment
Risk Factors
Treatment Outcome
Ureter pathology
Ureter surgery
Ureteral Calculi diagnosis
Ureteral Calculi surgery
Intraoperative Complications diagnosis
Intraoperative Complications etiology
Postoperative Complications diagnosis
Postoperative Complications etiology
Ureteral Calculi complications
Ureteral Obstruction etiology
Ureteral Obstruction surgery
Ureteroscopy adverse effects
Ureteroscopy methods
Subjects
Details
- Language :
- English
- ISSN :
- 1433-8726
- Volume :
- 35
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- World journal of urology
- Publication Type :
- Academic Journal
- Accession number :
- 28321499
- Full Text :
- https://doi.org/10.1007/s00345-017-2028-2