Predicting failed access in unstented ureteroscopy.

Female Humans Ureteroscopy Ureter Ureteroscopes Ureteral Calculi / surgery Constriction, Pathologic
Access Stent Ureteroscopy Urolithiasis

Journal

Urolithiasis
ISSN: 2194-7236
Titre abrégé: Urolithiasis
Pays: Germany
ID NLM: 101602699

Informations de publication

Date de publication:
28 Feb 2023
Historique:
received: 10 10 2022
accepted: 28 01 2023
entrez: 28 2 2023
pubmed: 1 3 2023
medline: 3 3 2023
Statut: epublish

Résumé

The risk of failed access (FA) in unstented ureteroscopy ranges from 7.7 to 16%, with young females and those with prior ipsilateral stone surgery, narrow ureteral anatomy, and proximal ureteral stone location carrying higher risk. We aim to determine the rate of failed access at our institution and analyze demographic, clinical, and operative variables associated with FA. We conducted a review of all unstented ureteroscopy procedures at our institution between January 2018 and June 2022. Ureteroscopy for stone, stricture, and neoplasm were included. The primary endpoint was rate of FA, when the unstented ureter failed to accommodate the ureteroscope distal to the target lesion. Demographic, clinical, and operative variables were analyzed to determine if there was an association with FA. Of the 562 ureteroscopies cases reviewed, 221 unstented ureteroscopies fit our inclusion criteria. FA occurred in 34 (15.4%). Previous stone passage (p = 0.039) and distal ureteral location (p = 0.042) were associated with successful access (SA). Proximal ureteral location was associated with FA (p = 0.008). These variables remained statistically significant when analyzed with multivariable logistic regression. There was no association with other demographic, clinical and operative variables. FA occurred at a rate of 15.4% at our institution. Previous stone passage and distal ureteral location were associated with SA, while proximal ureteral location was associated with FA. Prospective studies are needed to better determine predictors of FA.

Identifiants

DOI: 10.1007/s00240-023-01410-0 PMID: 36853378
pubmed: 36853378
doi: 10.1007/s00240-023-01410-0
pii: 10.1007/s00240-023-01410-0
doi:

Types de publication

Review Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

41

Commentaires et corrections

Type : ErratumIn

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Références

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Rubenstein RA, Zhao LC, Loeb S, Shore DM, Nadler RB (2007) Prestenting improves ureteroscopic stone-free rates. J Endourol 21(11):1277–1280. https://doi.org/10.1089/end.2007.9888
doi: 10.1089/end.2007.9888 pubmed: 18042014
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Auteurs

Kevin Morgan (K)

Department of Urology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA. Knmorgan91@gmail.com.
ORCID: 0000-0003-1255-3094

HarLee Possoit (H)

School of Medicine, LSU Health Shreveport, Shreveport, USA.

Zachary Conelly (Z)

School of Medicine, LSU Health Shreveport, Shreveport, USA.

Clifton F Frilot (CF)

School of Allied Health Professions, LSU Health Shreveport, Shreveport, USA.

Nazih Khater (N)

Department of Urology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA.

Alexander Gomelsky (A)

Department of Urology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Predicting failed access in unstented ureteroscopy.
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie urogénitale › Procédures de chirurgie urologique › Urétéroscopie › Predicting failed access in unstented ureteroscopy.
questionsmedicales.fr › Appareil urogénital › Voies urinaires › Uretère › Predicting failed access in unstented ureteroscopy.
questionsmedicales.fr › Équipement et fournitures › Équipement chirurgical › Endoscopes › Urétéroscopes › Predicting failed access in unstented ureteroscopy.
questionsmedicales.fr › États, signes et symptômes pathologiques › États anatomopathologiques › Calculs › Calculs urinaires › Calculs urétéraux › Predicting failed access in unstented ureteroscopy.
questionsmedicales.fr › États, signes et symptômes pathologiques › États anatomopathologiques › Sténose pathologique › Predicting failed access in unstented ureteroscopy.