Predictors for Negative Ureteroscopy in the Management of Upper Urinary Tract Stone Disease

Kreshover, Jessica; Dickstein, Rian J.; Rowe, Courtney K.; Babayan, Richard K.; Wang, David S.

doi:10.1016/j.urology.2011.03.008

Cited by 19 publications

(19 citation statements)

References 11 publications

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“…1). Eight full-text articles were obtained and finally 4 studies (1336 patients) were selected for our review [17][18][19][20]. These studies were published from 2011 to 2018, covering URS procedures carried out between 2003 and 2015.…”

Section: Resultsmentioning

confidence: 99%

“…They used a multivariate model which combined stone length, surface area, volume, and width on CT scan and found that smaller size significantly predicted negative URS (AUC 0.95; CI 0.92-0.97; p < 0.0001). Similarly, Kreshover et al found that stone size (p < 0.00) and location (p = 0.04) significantly predicted negative URS with higher rate of negative URS for small stones and stones located in the distal ureter [20].…”

Section: Negative Urs Rate and Predictive Factorsmentioning

confidence: 87%

“…Lamberts et al also found that female sex significantly predicted negative URS (OR 1.41; CI 1.25, 1.58; p < 0.05) [18]. Kreshover et al, however, did not find sex to be a significant predictive factor for negative URS [20]. Katafigiotis and colleagues also found that non-radiopaque stones significantly predicted negative URS (OR 11.11; CI 2.51, 49.20; p = 0.002) [17].…”

Section: Negative Urs Rate and Predictive Factorsmentioning

confidence: 96%

“…Katafigiotis and colleagues found no association for negative URS with anatomical site (divided by thirds of the ureter), body mass index (BMI), stone number or side and seasonal variation [17]. Similarly, Kreshover et al showed that the presence of preoperative pain, hydronephrosis, time interval since the initial CT scan and the use of medical expulsive therapy (MET) were not predictors of negative URS [20]. In the third study, Lamberts and team found that insurance type significantly predicted negative URS; however, race/ethnicity and the year of surgery did not predict negative URS [18].…”

Section: Negative Urs Rate and Predictive Factorsmentioning

confidence: 99%

“…The negative URS rate varied from 3.9 to 13.7% (Table 1) [17][18][19][20]. Three studies investigated potential predictive factors for a negative URS (Table 2) [17,18,20]. None of the studies found age to be a significant factor for negative URS.…”

Section: Negative Urs Rate and Predictive Factorsmentioning

confidence: 99%

See 4 more Smart Citations

‘Negative ureteroscopy’ for stone disease: Evidence from a systematic review

Rice¹,

Prattley²,

Pietropaulo³

et al. 2019

European Urology Supplements

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Purpose of Review While ureteroscopy (URS) is a common procedure for ureteric stones, this window between diagnosis and treatment leaves the possibility for a 'negative', 'stoneless' or 'diagnostic' URS. We perform a systematic review to look at the rate of 'negative ureteroscopy' and risk factors associated with it. Recent Findings From a total of 3599 articles and 68 abstracts, 4 studies (1336 patients) were selected. The negative URS rate varied from 4 to 14%. Common predictors seem to be female gender, small stones, radiolucent stones and distal ureteric stones. Summary Although infrequent, negative ureteroscopy should be avoided in patients with ureteric stones by performing a lowdose CT scan on the day of surgery. This should especially be performed for females and those with smaller, radiolucent or distal ureteric stones.

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Section: Resultsmentioning

confidence: 99%

Section: Negative Urs Rate and Predictive Factorsmentioning

confidence: 87%

Section: Negative Urs Rate and Predictive Factorsmentioning

confidence: 96%

Section: Negative Urs Rate and Predictive Factorsmentioning

confidence: 99%

Section: Negative Urs Rate and Predictive Factorsmentioning

confidence: 99%

See 3 more Smart Citations

‘Negative ureteroscopy’ for stone disease: Evidence from a systematic review

Rice¹,

Prattley²,

Pietropaulo³

et al. 2019

European Urology Supplements

View full text Add to dashboard Cite

show abstract

Optimising pre‐operative imaging–surgery intervals for stones

et al. 2023

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Introduction and objectivesThe NICE guidelines for acute ureteric colic recommend diagnostic imaging, definitive management and definitive care within 24 and 48 h of symptoms and 4 weeks of temporisation, respectively. However, the NHS reality is fraught with long waiting times to definitive treatment, further compounded by a progressively increasing stone burden, paucity of on‐site lithotripters and a decrease in non‐cancer elective theatre sessions during the COVID‐19 pandemic. By the time patients attended the elective surgeries, their reference images (RIs) were often significantly out of date. Scant direction exists on what interval between imaging and surgery invalidates the usefulness of the RIs in providing surgical guidance.This study aimed to evaluate the role of imaging–surgery intervals (ISIs) on upper tract stone negative surgery outcomes and derive a cut‐off ISI warranting updated images, with a view to improving efficiency and patient safety.Materials and methodsUpper tract stone surgeries were retrospectively assessed. Each renal unit was considered independently in bilateral stones. Cases were grouped into renal/pelvic (referred to as ‘RENAL’) and URETERIC stones. Data retrieved included the ISI, intra‐operative disparity (IOD) between stone‐related features on RIs and the surgical findings. Receiver operating curves (ROCs) were used to determine ISI cut‐offs more predictive of IODs.ResultsFour hundred and twenty‐seven surgeries on 174 (40.7%) RENAL and 253 (59.3%) URETERIC stones were appraised. No stones were found intraoperatively in 52 (12.1%) patients. Longer ISIs were associated with IODs, especially with URETERIC stones (p = 0.011, CI95 0.63; 4.84). The derived ROC ISI cut‐offs beyond which IODs, including negative surgeries, were more likely were 9 weeks for URETERIC (AUC: 63%, CI95 0.56; 0.70) and 19 weeks (AUC: 58.6%, CI95 0.50; 0.68) for RENAL stones, respectively.ConclusionThere is a need to update reference imaging done more than 9 or 19 weeks before surgery for URETERIC and RENAL stones, respectively.

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Ureteroscopy for Ureteral Stones: Case Discussion of Impacted Stone

Snow-Lisy

Monga

2013

Surgical Management of Urolithiasis

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Predictors for Negative Ureteroscopy in the Management of Upper Urinary Tract Stone Disease

Cited by 19 publications

References 11 publications

‘Negative ureteroscopy’ for stone disease: Evidence from a systematic review

‘Negative ureteroscopy’ for stone disease: Evidence from a systematic review

Optimising pre‐operative imaging–surgery intervals for stones

Ureteroscopy for Ureteral Stones: Case Discussion of Impacted Stone

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