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Patients with urological pathology often develop supravesical obstruction (SVO), which affects the renal parenchyma and causes disruption of the normal renal function and various complications, such as chronic renal disease and urosepsis, which can lead to death. Prediction accuracy assessment for this group of patients is challenging, making it difficult to draw firm conclusions Objective: To develop predictive models for choosing rational treatment tactics in SVO. Methods: Data from 655 patients aged 4 to 86 (average age 39.56±17.23 years) admitted to the Republican Specialized Scientific and Practical Medical Center of Urology in 2021-2023 with SVO were analyzed. There were 350 men (53.4%) and 305 women (46.6%) enrolled in the study. Patients were divided into groups according to the primary diagnoses: urolithiasis (UL) – 231 (35.3%), anomalies of the upper urinary tract (UUT) – 332 (50.7%), acquired diseases of the ureter – 92 (14.0%). Results: Critical Z-values (cut-off points) were calculated for each group, determining the complicated course of SVO. In the UL group, the Z-value was 1.910; in the group of patients with anomalies of the UUT, ureteropelvic stricture (UPS) – 1.998, ureteral stricture – 1.239, ureterocele – 1.894; in the group of patients with acquired diseases of the ureter, secondary ureteral strictures – 1.209, ureteral obliteration – 1.713. Conclusion: Discriminant prediction models showed high sensitivity and specificity for choosing the optimal tactical approach in patients with complicated SVO. Keywords: Supravesical obstruction, hydronephrosis, prediction model, management tactics.
Patients with urological pathology often develop supravesical obstruction (SVO), which affects the renal parenchyma and causes disruption of the normal renal function and various complications, such as chronic renal disease and urosepsis, which can lead to death. Prediction accuracy assessment for this group of patients is challenging, making it difficult to draw firm conclusions Objective: To develop predictive models for choosing rational treatment tactics in SVO. Methods: Data from 655 patients aged 4 to 86 (average age 39.56±17.23 years) admitted to the Republican Specialized Scientific and Practical Medical Center of Urology in 2021-2023 with SVO were analyzed. There were 350 men (53.4%) and 305 women (46.6%) enrolled in the study. Patients were divided into groups according to the primary diagnoses: urolithiasis (UL) – 231 (35.3%), anomalies of the upper urinary tract (UUT) – 332 (50.7%), acquired diseases of the ureter – 92 (14.0%). Results: Critical Z-values (cut-off points) were calculated for each group, determining the complicated course of SVO. In the UL group, the Z-value was 1.910; in the group of patients with anomalies of the UUT, ureteropelvic stricture (UPS) – 1.998, ureteral stricture – 1.239, ureterocele – 1.894; in the group of patients with acquired diseases of the ureter, secondary ureteral strictures – 1.209, ureteral obliteration – 1.713. Conclusion: Discriminant prediction models showed high sensitivity and specificity for choosing the optimal tactical approach in patients with complicated SVO. Keywords: Supravesical obstruction, hydronephrosis, prediction model, management tactics.
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