Developing a preoperative predictive model for ureteral length for ureteral stent insertion

Abstract

BackgroundUreteral stenting has been a fundamental part of various urological procedures. Selecting a ureteral stent of optimal length is important for decreasing the incidence of stent migration and complications. The aim of the present study was to develop and internally validate a model for predicting the ureteral length for ureteral stent insertion.MethodsThis study included a total of 127 patients whose ureters had previously been assessed by both intravenous urography (IVU) and CT scan. The actual ureteral length was determined by direct measurement using a 5-Fr ureteral catheter. Multiple linear regression analysis with backward selection was used to model the relationship between the factors analyzed and actual ureteral length. Bootstrapping was used to internally validate the predictive model.ResultsPatients all of whom had stone disease included 76 men (59.8%) and 51 women (40.2%), with the median and mean (± SD) ages of 60 and 58.7 (±14.2) years. In these patients, 53 (41.7%) right and 74 (58.3%) left ureters were analyzed. The median and mean (± SD) actual ureteral lengths were 24.0 and 23.3 (±2.0) cm, respectively. Using the bootstrap methods for internal validation, the correlation coefficient (R2) was 0.57 ± 0.07.ConclusionWe have developed a predictive model, for the first time, which predicts ureteral length using the following five preoperative characteristics: age, side, sex, IVU measurement, and CT calculation. This predictive model can be used to reliably predict ureteral length based on clinical and radiological factors and may thus be a useful tool to help determining the optimal length of ureteral stent.

Comparison of external stents and DJ stents techniques for pediatric pyeloplasty: A systematic review and meta-analysis

“…Concerning the result of overall complications, we did not find significant differences between the external stent group and the DJ stent group, which was consistent with most previous studies ( 3 , 4 , 18 ). Some studies have suggested that several postoperative problems can be avoided by choosing a suitable stent length and some tools were offered for choice ( 27 , 28 ). To avoid the excess length of the stent in the bladder, Professor Garg proposed the formula: Length of DJ stent (cm) = length of the retained ureter (cm)−2.…”

Biodegradation behavior of magnesium and ZK60 alloy in artificial urine and rat models

“…Ureteral injury usually leads to obstruction, hydronephrosis, renal damage, infection, urinary cysts and other urinary system complications, which seriously affect the quality of a patient's life [3] , [4] , [5] . After an operation, a ureteral injury is usually treated with a ureteral stent, which is placed in the repair site to maintain urinary tract patency and prevent ureteral restenosis [6] , [7] . Traditional ureteral stents are usually made by inert materials, e.g., stainless steel and polyurethane, which may cause long-term complications, such as infection, pain, hematuria and the formation of capsids and stones.…”

A descriptive study to analysis the ureteral length in adult population

“…Moreover the methods for choosing an appropriate stent length by using a formula based on the patient's height are derived mostly from the data of western population, who are relatively taller than Asians. Whether these data are applicable to Asians is unclear [5]. There is no standard and simplified method for determining the appropriate ureteral stent length that prevents a decline in urination-related quality of life.…”