Peri-Calculus Ureteral Thickness on Computed Tomography Predicts Stone Impaction at Time of Surgery: A Prospective Study

Chandhoke, Ryan; Bamberger, Jacob; Gallante, Blair; Atallah, William; Gupta, Mantu

doi:10.1089/end.2019.0449

Cited by 10 publications

(11 citation statements)

References 13 publications

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“…Not only stone parameters but also ureteral characteristics on imaging should be considered in the decision to proceed with URS versus PCN. We have identified stone impaction as an additional parameter that predicts clinical outcome [15,16,20]. Stone impaction can be explained by pathological changes in the ureteral wall, such as edema and hypertrophy at the site of the stone [21].…”

Section: Discussionmentioning

confidence: 99%

“…Numerous studies have highlighted the predictors for stone impaction during URS and determined preoperative radiological parameters such as increased ureteral wall thickness and ureteral wall density at the stone level to be predictors for stone impaction [15,16,23]. Higher PUD below the stone level has been considered to be another co-factor responsible for URS failure as it may represent more ureteral inflammation and spasm precluding passage of the ureteroscope to reach stones [15,16]. Other studies have found the severity of hydronephrosis and increased serum creatinine to be associated with impacted ureteral stones during URS [24,25].…”

Section: Discussionmentioning

confidence: 99%

“…The pericalcular ureteric thickness (P-CUT) was measured as the widest transverse measurement of the ureter involving the stone and the corresponding maximum transverse diameter of the stone at this level. P-CUT was then calculated by subtracting the stone width from the overall stone and ureteral width [16] (Figure 1). Radiological data were interpreted by 2 expert radiologists (> 10 years' experience) blinded to the study objectives.…”

Section: Radiological Measurements For P-cut and Pud At And Below The Stone Levelmentioning

confidence: 99%

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Predictors for Retrograde Ureteral Stenting Failure as an Initial Drainage Method for Emergent Complicated Acute Calculus Obstructive Uropathy

Elbaset¹,

Edwan²,

Abouelkheir³

et al. 2021

Société Internationale D’Urologie Journal

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Objective: To define predictors for initial retrograde ureteral stenting (RUS) failure with the need for the percutaneous nephrostomy (PCN) insertion as a drainage method in patients with complicated acute calculus obstructive uropathy. Methods: We undertook a retrospective evaluation of patients who presented with complicated obstructive calculus uropathy (acute renal failure or obstructive pyelonephritis) between January 2016 and January 2020. Patients in whom there was failure to visualize ipsilateral ureteric orifice and those with extrinsic ureteral obstruction were excluded. Patient demographics and radiological data including stone site, hydronephrosis grade, maximum transverse stone diameter, periureteral density (PUD) and pericalcular ureteric thickness (P-CUT) at the maximum transverse stone diameter were assessed using non-contrast computed tomography at the time of admission. Results: The study included 256 patients who were managed initially by RUS trial. Of them, 48 (18.8 %) had RUS failure. The presence of acute pyelonephritis, increased maximum transverse stone diameter ≥ 9.5 mm, P-CUT ≥ 7.5 mm, and PUD at stone level ≥ 17.5 HU were risk factors associated with RUS failure (P = 0.007, 0.002, < 0.001, and < 0.001, respectively). Conclusion: Initial radiological stone and ureteric characteristics, in addition to the clinical diagnosis of obstructive pyelonephritis, can be used to determine PCN insertion as the preferred option over RUS for urinary drainage.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Radiological Measurements For P-cut and Pud At And Below The Stone Levelmentioning

confidence: 99%

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Predictors for Retrograde Ureteral Stenting Failure as an Initial Drainage Method for Emergent Complicated Acute Calculus Obstructive Uropathy

Elbaset¹,

Edwan²,

Abouelkheir³

et al. 2021

Société Internationale D’Urologie Journal

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“…prospectively measured four ureteral thickness parameters (ureteral thickness above, around and below the calculus, and peri‐calculus ureteral thickness surface area) by using preoperative NCCT images. They evaluated the association between these parameters and endoscopic stone impaction (determined by surgeons using a 10‐point Likert scale), in patients who underwent URSL 9 . All four of these parameters were associated with ureteral stone impaction.…”

Section: Preoperative Prediction Of Stone Impactionmentioning

confidence: 99%

“…They evaluated the association between these parameters and endoscopic stone impaction (determined by surgeons using a 10-point Likert scale), in patients who underwent URSL. 9 All four of these parameters were associated with ureteral stone impaction. Wang et al developed and validated a nomogram for prediction of ureteral stone impaction, which was defined as impossibility of guidewire passage on the initial attempt.…”

Section: Introductionmentioning

confidence: 97%

Comprehensive endoscopic management of impacted ureteral stones: Literature review and expert opinions

et al. 2022

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Treatment of urolithiasis, a benign disease, requires high efficacy and safety. Endoscopic treatment of impacted ureteral stones remains a challenging procedure for urologists, despite recent remarkable advances in surgical technology in treatment of urolithiasis. The success rate of endoscopic treatment in patients with impacted stones is reported to be lower than that in patients with nonimpacted stones. Moreover, the presence of stone impaction is associated with high rates of intraoperative and postoperative complications. The best management for patients with impacted ureteral stones should therefore be devised based on the latest knowledge and techniques. The present review focuses on the preoperative prediction of stone impaction, the safest and most effective endoscopic surgical procedures, and the most appropriate management for postoperative ureteral strictures. We overview comprehensive endoscopic management for impacted ureteral stones based on literature review and expert opinions.

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Predictive value of NCCT quantitative analysis for proximal and middle impacted ureteral stones

Wei,

Shi,

et al. 2024

Urolithiasis

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Peri-Calculus Ureteral Thickness on Computed Tomography Predicts Stone Impaction at Time of Surgery: A Prospective Study

Cited by 10 publications

References 13 publications

Predictors for Retrograde Ureteral Stenting Failure as an Initial Drainage Method for Emergent Complicated Acute Calculus Obstructive Uropathy

Predictors for Retrograde Ureteral Stenting Failure as an Initial Drainage Method for Emergent Complicated Acute Calculus Obstructive Uropathy

Comprehensive endoscopic management of impacted ureteral stones: Literature review and expert opinions

Predictive value of NCCT quantitative analysis for proximal and middle impacted ureteral stones

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