Characteristics and outcomes of ureteroscopic treatment in 2650 patients with impacted ureteral stones.

Legemate, Jaap D; Wijnstok, Nienke J; Matsuda, Tadashi; Strijbos, Willem; Erdogru, Tibet; Roth, Beat; Kinoshita, Hidefumi; Palacios-Ramos, Judith; Scarpa, Roberto M; de la Rosette, Jean J (2017). Characteristics and outcomes of ureteroscopic treatment in 2650 patients with impacted ureteral stones. World journal of urology, 35(10), pp. 1497-1506. Springer 10.1007/s00345-017-2028-2

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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.

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.

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.

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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Urology

UniBE Contributor:

Roth, Beat

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0724-4983

Publisher:

Springer

Language:

English

Submitter:

Laetitia Hayoz

Date Deposited:

07 Mar 2018 17:38

Last Modified:

12 Mar 2021 05:45

Publisher DOI:

10.1007/s00345-017-2028-2

PubMed ID:

28321499

Uncontrolled Keywords:

Complications Impacted stones Treatment outcomes Ureter Ureteroscopy Urolithiasis

BORIS DOI:

10.7892/boris.108765

URI:

https://boris.unibe.ch/id/eprint/108765

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