Clinical factors associated with postoperative hydronephrosis after ureteroscopic lithotripsy

Abstract

PurposeThis study aimed to determine the predictors of ipsilateral hydronephrosis after ureteroscopic lithotripsy for ureteral calculi.Materials and MethodsFrom January 2010 to December 2014, a total of 204 patients with ureteral calculi who underwent ureteroscopic lithotripsy were reviewed. Patients with lack of clinical data, presence of ureteral rupture, and who underwent simultaneous percutaneous nephrolithotomy (PNL) were excluded. Postoperative hydronephrosis was determined via computed tomographic scan or renal ultrasonography, at 6 months after ureteroscopic lithotripsy. Multivariable analysis was performed to determine clinical factors associated with ipsilateral hydronephrosis.ResultsA total of 137 patients were enrolled in this study. The mean age of the patients was 58.8±14.2 years and the mean stone size was 10.0±4.6 mm. The stone-free rate was 85.4%. Overall, 44 of the 137 patients (32.1%) had postoperative hydronephrosis. Significant differences between the hydronephrosis and nonhydronephrosis groups were noted in terms of stone location, preoperative hydronephrosis, impacted stone, operation time, and ureteral stent duration (all, p<0.05). On multivariable analysis, increasing preoperative diameter of the hydronephrotic kidney (adjusted odds ratio [OR], 1.21; 95% confidence interval [CI], 1.12–1.31; p=0.001) and impacted stone (adjusted OR, 3.01; 95% CI, 1.15–7.61; p=0.031) independently predicted the occurrence of postoperative hydronpehrosis.ConclusionsLarge preoperative diameter of the hydronephrotic kidney and presence of impacted stones were associated with hydronephrosis after ureteroscopic stone removal. Therefore, patients with these predictive factors undergo more intensive imaging follow-up in order to prevent renal deterioration due to postoperative hydronephrosis.

Ureterorenoscopic (URS) Lithotripsy and Balloon Dilation Cause Acute Kidney Injury and Distal Renal Tubule Damage: A Prospective Study

“…Few studies have investigated the factors associated with the development of ipsilateral postoperative hydronephrosis in patients who underwent URS [ 35 , 36 ]. The incidence was reported to range from 15.0% to 32.1% [ 37 ]. A larger stone size, longer operation time, and prior ipsilateral URS procedure were associated with an increased risk of postoperative hydronephrosis.…”

The Innovative Use of Ureter Catheter in the Surgery of Obstructive Uropathy

“…Meanwhile, a series of complications caused by ureteroscopy have received increased attention including early postoperative hematuria, urosepsis, and urinary tract injury, along with late postoperative ureteral stricture, hydronephrosis, and kidney function decline, etc. [6][7][8][9][10]. In addition to the stone itself, there are also iatrogenic causes in the occurrence of complications, such as nuclear surgical field of vision, prolonged operation time, and applying energy on the mucosa.…”

Outcomes of ureteral stent placement for hydronephrosis in patients with ureteral stone

“…One study stated that patients with a solitary kidney or on anticoagulant use and with preoperative double-J stent were less likely to have a postoperative double-J stent placed. (12,13) The operative duration was calculated from ureteral opening until the stone was removed or crushed. The duration of URS surgery increased when stent insertion was performed; in this case there was a statistically significant difference in the duration as compared with no stent insertion.…”