Evaluation of ureteral injuries caused by ureteral access sheath insertion during ureteroscopic lithotripsy.
lithotripsy
ureteral access sheath
ureteral calculi
ureteral injuries
ureteroscopy
Journal
International journal of urology : official journal of the Japanese Urological Association
ISSN: 1442-2042
Titre abrégé: Int J Urol
Pays: Australia
ID NLM: 9440237
Informations de publication
Date de publication:
06 2023
06 2023
Historique:
received:
17
10
2022
accepted:
26
02
2023
medline:
6
6
2023
pubmed:
26
3
2023
entrez:
25
3
2023
Statut:
ppublish
Résumé
To evaluate ureteral injuries caused by insertion of a 13-Fr ureteral access sheath and identify factors (other than pre-stenting) that are predictive of ureteral injury. We enrolled 201 patients who underwent ureteroscopic lithotripsy (URSL). We excluded 80 patients who underwent ureteral stent insertion before URSL, 10 patients who did not use a ureteral access sheath, and 2 patients in whom a ureteral access sheath could not be inserted. In total, 109 patients were analyzed; all underwent insertion of a 13-Fr ureteral access sheath. We investigated ureteral injuries using the Traxer ureteral injury scale. There were 21 (19.3%) cases of ureteral access sheath-related ureteral injury, including 11 (10.1%) grade 2 cases and 10 (9.2%) grade 3 cases. The ureteral injury location was the proximal ureter in 20 cases (18.3%), middle ureter in one case (0.9%), and distal ureter in zero cases. Multiple logistic regression analysis showed that male sex and smaller stone diameter were significant predictive factors for ureteral injury (p = 0.037, odds ratio [OR]: 5.19, 95% confidence interval [CI]: 1.11-24.3 and p = 0.02, OR: 0.83, 95% CI: 0.71-0.97, respectively). Postoperative ureteral stricture did not occur in any cases. The rate of ureteral injury caused by a 13-Fr ureteral access sheath was considerable, and most ureteral injuries occurred in the proximal ureter. Male sex and smaller stone diameter were significant predictive factors for ureteral injury. The proximal ureter should be confirmed when using a 13-Fr ureteral access sheath, particularly in male patients and patients with small stones.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
554-558Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2023 The Japanese Urological Association.
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