Predictive Factors of Ureterorenoscopy Outcomes in Proximal Ureteral Stones: A Multicenter Study of Aegean Study Group of the Society of Urological Surgery

Abstract

<b><i>Introduction:</i></b> We aimed to evaluate the predictive factors in a holistic manner for ureterorenoscopy (URS) outcomes in proximal ureteral stones by a multicenter study. <b><i>Materials and Methods:</i></b> The data of patients who underwent URS for proximal ureteral stones between the years 2015 and 2018 in eight centers were recorded retrospectively. Patients were divided into two groups according to URS success: Group 1 consisted of patients with successful URS, and Group 2 consisted of patients with unsuccessful URS. The two groups were compared in terms of risk factors, stone, and clinical characteristics of patients. <b><i>Results:</i></b> A total of 638 patients were included in the study. Group 1 consisted of 527 (82.6%) patients, and Group 2 consisted of 111 (17.4%) patients. In multivariate logistic analysis, the key risk factors for URS success was found to be age (OR = 0.980, 95% [CI] = 0.963–0.996, <i>p</i> = 0.018), stone area (OR = 0.993, 95% [CI] = 0.989–0.997, <i>p</i> = 0.002), and operation time (OR = 0.981, 95% [CI] = 0.968–0.994, <i>p</i> = 0.005). <b><i>Conclusions:</i></b> To make the treatment decision of proximal ureteral stones, it is necessary to examine several parameters including available equipment, stone, and patient characteristics. Physicians should keep these risk factors in mind in the decision of treatment options.

External Validation of the S.T.O.N.E. Score in Predicting Stone-Free Status After Rigid Ureteroscopic Lithotripsy

“…Turunc et al 16 studied the factors that affect the success of rURS for ureteral stones in pediatric patients, and they demonstrated a significant reverse correlation between stone size and SFR (p = 0.007). In a multicenter study, Sen et al 17 retrospectively evaluated, in a holistic manner, the predictive factors from URS involving upper ureteral stones. They found that stone area is one of the key risk factors affecting URS success (OR = 0.993, p = 0.002).…”

Factors Affecting Success of Semi-rigid Ureterorenoscopy in Proximal Ureter Stone Treatment

“…Sen, Sancak, Günlüsoy and Bangash reported that stone size is associated with the success rate of semi-rigid ureteroscopy in proximal ureteral stone. 2,6,10,12 There are studies that claim the opposite. [13][14][15] In this study, the size of stones were similar in both the groups (p=0.903).…”

“…Urologists consider many factors, such as location of stone, stone size, patient's age, degree of hydro nephrosis, symptom severity, accompanying bacterial infection, status of solitary kidney, patient expectations and technical equipment, when making treatment decisions. 2 Stones smaller than 5 mm are more suitable for spontaneous passage through the ureter.…”

“…11 Several studies have been done to find out the factors affecting the success of URSL for proximal ureteral stones. 2,12 Many factors affect the ureteroscopy's success, like age, gender, stone size, stone density, impacted stone history, and lithotripter type (laser or pneumatic).…”

Impact of Multiparametric Stone Measurement in Noncontrast Computer Tomography on Ureterorenoscopic Stone Removal

“…Other studies have reported different probabilities: up to 47% (36-48%) with a stone size of 5-10 mm and 68% (46-85%) with a stone size of <5 mm [7]. Ultimately, it is important for clinicians to discuss these options with the patient and for them to decide together whether to carry out an endoscopic procedure or wait for spontaneous stone passage with regular follow-up [8,9]. Thus, an exact measurement of stone size is very important to help facilitate these discussions with the patient.…”