Average, and Maximum Ureteral Wall Thickness are Predictor Factor for Ureteroscopy Outcomes?

Abstract

Objective: The aim of our study is to investigate the effect of average and maximum ureteral wall thicknesses measured by computed tomography before the operation on ureteroscopy results.

Materials and Methods: This prospective study was conducted with 103 patients who underwent ureteroscopy for ureteral stones between July and December 2021. The maximum ureteral wall thickness in the region of the ureteral stone and the average of the ureteral wall thicknesses measured from the 3-6-9-12 lines were calculated by non-contrast computed tomography. The operation time, residual stone, double j insertion status, and intraoperative complication status were examined according to the average ureteral wall thickness and maximum wall thickness.

Results: Of the 103 patients included in the study, 77 were male, and 26 were female. The mean age of the patients was 43.83±15.11 years. The mean stone length was 10.76±3.84 mm. The average ureteral wall thickness was 3.81±1.24 mm, while the maximum ureteral wall thickness was 4.9±1.8 mm. It was found that as the maximum, and average ureteral wall thickness increased, the operation time, residual stone, double insertion rate, and post-ureteroscopic lesion scale grade increased (p<0.05).

Conclusion: Maximum and average ureteral wall thicknesses are predictive factors for ureteroscopy results. 

Keywords

• Tomography
• ureteral calculi
• ureteral wall thickness
• ureteroscopy

Ortalama ve Maksimum Üreter Duvar Kalınlığı Üreteroskopi Sonuçları için Öngörücü Faktör müdür?

Öz

Amaç: Çalışmamızın amacı operasyon öncesi bilgisayarlı tomografi ile ölçülen ortalama ve maksimum üreter duvar kalınlıklarının üreteroskopi sonuçları üzerindeki etkisini araştırmaktır.

Materyal ve Metot: Bu prospektif çalışma Temmuz-Aralık 2021 tarihleri arasında üreter taşı nedeniyle üreteroskopi yapılan 103 hasta ile yapılmıştır. Kontrastsız bilgisayarlı tomografi ile üreter taşının olduğu bölgedeki maksimum üreter duvar kalınlığı ve 3-6-9-12 hizalarından ölçülen üreter duvar kalınlıkları ortalaması alındı. Ortalama üreter duvar kalınlığı ve maksimum duvar kalınlığına göre operasyon süresi, rezidü taş ve double j takılma durumu ve intraoperative komplikasyon durumu incelendi.

Bulgular: Çalışmaya dahil edilen 103 hastanın 77’si erkek, 26’sı kadındı. Hastaların yaş ortalaması 43,83±15,11 yıl idi. Ortalama taş uzunluğu 10,76±3,84 mm idi. Maksimum üreter duvar kalınlığı 4,9±1,8 mm iken ortalama üreter duvar kalınlığı 3,81±1,24 mm idi. Maksimum ve ortalama üreter duvar kalınlığı artıkça operasyon süresi, rezidü taş ve double takılma oranı, post üreteroskopik lezyon skala derecesinin arttığı görüldü (p<0,05).

Sonuç: Maksimum ve ortalama üreter duvar kalınlıkları üreteroskopi sonuçlarını öngörmede prediktif faktörlerdir. 

Anahtar Kelimeler

• Tomografi
• üreter duvar kalınlığı
• üreter taşı
• üreteroskopi

Kaynakça

1. Prasad D, Satani Y, Singh S, Gajera D. A prospective comparative study of ureterorenoscopy with and without DJ stenting for the management of ureteric stones. Int. Surg J. 2021;8(12):3606-3614. doi:10.18203/2349-2902.isj20214753
2. Okçelik S, Kurul NO, Kiziloz H, Temel MC, Yesildal C. Factors affecting success of semi-rigid ureterorenoscopy in proximal ureter stone treatment. J Coll Physicians Surg Pak. 2021;31(1):65-69. doi:10.29271/jcpsp.2021.01.65
3. Taken, K, Parlak M, Günes et al. The urinary system ınfections caused by extended-spectrum-B-lactamase-producing Escherichia coli and Klebsiella pneumoniae strains. East  J Med. 2016;21(1):31-37.
4. Tran TY, Bamberger JN, Blum KA, et al. Predicting the ımpacted ureteral stone with computed tomography. Urology. 2019;130:43-47. doi:10.1016/j.urology.2019.04.020
5. Sarica K, Kafkasli A, Yazici Ö, et al. Ureteral wall thickness at the impacted ureteral stone site: a critical predictor for success rates after SWL. Urolithiasis. 2015;43(1):83-88. doi:10.1007/s00240-014-0724-6
6. Jendeberg J, Geijer H, Alshamari M, Cierzniak B, Lidén M. Size matters: The width and location of a ureteral stone accurately predict the chance of spontaneous passage. Eur Radiol. 2017;27(11):4775-4785. doi:10.1007/s00330-017-4852-6
7. May M, Schönthaler M, Gilfrich C, et al. Interrater reliability and clinical impact of the Post-Ureteroscopic Lesion Scale (PULS) grading system for ureteral lesions after ureteroscopy: Results of the German prospective multicenter BUSTER project. Urologe A. 2018;57(2):172-180. doi:10.1007/s00120-017-0565-3
8. Sarica K, Eryildirim B, Akdere H, Karagoz MA, Karaca Y, Sahan A. Predictive value of ureteral wall thickness (UWT) assessment on the success of internal ureteral stent insertion in cases with obstructing ureteral calculi. Urolithiasis. 2021;49(4):359-365. doi:10.1007/s00240-020-01233-3

9. Yoshida T, Inoue T, Taguchi M, Omura N, Kinoshita H, Matsuda T. Ureteral wall thickness as a significant factor in predicting spontaneous passage of ureteral stones of ≤ 10 mm: a preliminary report. World J Urol. 2019;37(5):913-919. doi:10.1007/s00345-018-2461-x
10. Tonyalı Ş, Yılmaz M, Karaaslan M, Ceylan C, Işıkay L. Prediction of stone-free status after single-session retrograde intrarenal surgery for renal stones. Turk J Urol. 2018;44(6):473-477. doi:10.5152/tud.2018.88615
11. Yamashita S, Kohjimoto Y, Iguchi T, Nishizawa S, Kikkawa K, Hara I. Ureteral wall volume at ureteral stone site is a critical predictor for shock wave lithotripsy outcomes: comparison with ureteral wall thickness and area. Urolithiasis. 2020;48(4):361-368. doi:10.1007/s00240-019-01154-w
12. Dede O, Şener NC, Baş O, Dede G, Bağbancı MŞ. Does morbid obesity influence the success and complication rates of extracorporeal shockwave lithotripsy for upper ureteral stones? Turk J Urol. 2015;41(1):20-23. doi:10.5152/tud.2015.94824
13. Selvi I, Baydilli N, Tokmak TT, Akinsal EC, Basar H. CT-related parameters and Framingham score as predictors of spontaneous passage of ureteral stones ≤ 10 mm: results from a prospective, observational, multicenter study. Urolithiasis. 2021;49(3):227-237. doi:10.1007/s00240-020-01214-6
14. Mugiya S, Ito T, Maruyama S, Hadano S, Nagae H. Endoscopic features of impacted ureteral stones. J Urol. 2004;171(1):89-91. doi:10.1097/01.ju.0000100960.08768.81
15. Ventimiglia E, Godínez AJ, Traxer O, Somani BK. Cost comparison of single-use versus reusable flexible ureteroscope: A systematic review. Turk J Urol. 2020;46(Supp. 1):40-45. doi:10.5152/tud.2020.20223
16. Guzelburc V, Guven S, Boz MY, et al. Intraoperative evaluation of ureteral access sheath-related ınjuries using post-ureteroscopic lesion scale. J Laparoendosc Adv Surg Tech A. 2016;26(1):23-26. doi:10.1089/lap.2015.0294
17. Al-Naimi A, Alobaidy A, Majzoub A, Ibrahim TA. Evaluation of ureteroscopy outcome in a teaching hospital. Turk J Urol. 2016;42(3):155-161. doi:10.5152/tud.2016.17037