Ureteral Strictures Following Ureteroscopic Stone Treatment

Ulvik, Øyvind; Harneshaug, Jill-Randi; Gjengstø, Peder

doi:10.1089/end.2020.0421

Cited by 37 publications

(21 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our unit is a tertiary referral centre for adult URS and this lends itself to transferring this expertise to the paediatric setting. 40 Scrutiny of published series reveals that the majority arise from a small pool of nations with common characteristics. Either stone disease is endemic in that country (e.g.…”

Section: Discussionmentioning

confidence: 99%

Ureteroscopy for stone disease in the paediatric population: lessons learned and outcomes in a Nordic setting

Juliebø‐Jones

Æsøy

Gjengstø

et al. 2022

Therapeutic Advances in Urology

Self Cite

View full text Add to dashboard Cite

Introduction: Paediatric stone disease is rare in the Nordic communities. Still, the condition can require surgical intervention in the form of ureteroscopy (URS). Here, we report outcomes achieved at a regional (tertiary) centre. Patients and methods: Retrospective analysis was performed of consecutive patients (<18 years of age) undergoing URS for stone disease between 2010 and 2021. Outcomes of interest included stone-free rate (SFR) determined using a definition of no residual fragments ⩾ 3 mm on imaging and complications classified according to Clavien–Dindo system. Results: In total, 23 patients underwent 47 URS procedures for a total of 31 stone episodes. Mean age was 9 (range 1–17) years and male-to-female ratio was 6:17. Overall, 35% had at least one medical comorbidity. Ultrasound determined preoperative stone status in 87%. Mean largest index and cumulative stone sizes were 9 (range 3–40) and 12 (range 3–40) mm, respectively. Overall, 32% had multiple stones. Lower pole was the commonest stone location (39%). No patients underwent elective pre-operative stenting. Ureteral access sheaths were not used in any cases. Access to upper urinary tract at first procedure was successful in 94%. Initial and final SFR was 61% and 90%, respectively. No intra-operative complications were recorded. Overall post-operative complication rate was 17.5%. Urinary tract infection (CD II) was the commonest adverse event (12.5%). Conclusion: Paediatric URS can be delivered in the setting of a regional centre without compromising outcomes. This includes when carried out by adult endourologists, without routine pre-stenting and omitting use of ureteric access sheath.

show abstract

Section: Discussionmentioning

confidence: 99%

Ureteroscopy for stone disease in the paediatric population: lessons learned and outcomes in a Nordic setting

Juliebø‐Jones

Æsøy

Gjengstø

et al. 2022

Therapeutic Advances in Urology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Usually, ureteroscopy is extended by flexible endoscopy of the kidney for the treatment of calyceal stones. This results in longer operating time and potentially in a higher risk for complications such as septicaemia and ureteric injury [16, 17].…”

Section: Discussion/conclusionmentioning

confidence: 99%

Urolithiasis in Germany: Trends from the National DRG Database

et al. 2021

View full text Add to dashboard Cite

Introduction: Urolithiasis is a common disease leading to a high socioeconomic burden due to treatment costs and sickness leave. The aim of this study was to evaluate recent trends in the incidence of urolithiasis in Germany and in the use of therapeutic interventions. Methods: Treatment data for all in-patient hospital episodes for urolithiasis between 2005 and 2016 were extracted from the national DRG statistics at DESTATIS and analysed with regard to the corresponding procedures according to the OPS code. Results: Incidence for urolithiasis was stable at around 120,000 cases per year during the observation period with a male:female ratio of 2:1. Rising numbers were noted for patients >80 years. Nevertheless, the number of coded procedures rose significantly with a marked disproportionate transition from extracorporeal shock wave lithotripsy towards ureterorenoscopy. Percutaneous nephrolithotomy was performed more frequently on a smaller scale. Discussion/Conclusion: While the global incidence of urolithiasis is still rising, Germany, as other Western countries, has reached a plateau. There is a remarkable trend towards invasive treatment of even asymptomatic kidney stones. Besides the effects on individual patients with increased risk for complications, this results in a higher monetary burden to the health care system and society.

show abstract

“…There were only 4 cases of Ureteral stricture in the article [3] . There are many speculations about the mechanism of ureteral stenosis after Ureteroscopic surgery, such as stone impaction, soft sheath compression injury, large stone burden, intraoperative ureteral perforation and the surgeon's experience [2,11]. Daniel A Wollin et al designed an in vitro model to study the water temperature at different perfusion rates during holmium laser lithotripsy.…”

Section: Discussionmentioning

confidence: 99%

Effect of Preoperative Hydronephrosis on Ureteral Stenosis after Flexible Ureteroscopy: A Propensity Scores Matching Analysis

Shen¹,

Xiang²,

Shao³

2021

Preprint

View full text Add to dashboard Cite

OBJECTIVES: Ureteral stenosis is a serious complication after flexible ureteroscopy. Other studies have confirmed that stone impaction and intraoperative ureteral injury are important factors causing stricture, and how to predict the occurrence of stricture before surgery may be an important topic. This study retrospectively studied the influence of preoperative hydronephrosis degree on ureteral stenosis after flexible ureteroscopy to explore whether preoperative hydronephrosis degree could predict postoperative ureteral stenosis. METHODS: A retrospective study was conducted on patients who received flexible ureteroscopy in our hospital for upper ureteral calculi from January 2015 to June 2018. The postoperative follow-up was performed for 36 months, and intraoperative and postoperative complications were recorded. According to the degree of hydronephrosis, the patients were divided into mild hydronephrosis group and moderate and severe hydronephrosis group. Preoperative clinical baseline data of the patients were adjusted by propensity matching score, and differences in intraoperative mucosal injury, operative time, incidence of postoperative ureteral stricture, and SFR 1 month after surgery were statistically analyzed. Kaplan-Meier method and Log-rank test were used to compare the differences in the cumulative incidence of ureteral stenosis between the two groups. Cox regression analysis was used to compare the hazard ratio of ureteral stenosis between the two groups. RESULTS: A total of 447 patients with 469 sides surgery were included, including 349 sides in the mild hydronephrosis group and 120 sides in the moderate and severe hydronephrosis group. 30 sides in 29 patients developed ureteral stenosis. The stenosis rate before propensity matching analysis was 6.4%, and 8% after propensity matching analysis. However, the SFR and operation time were not statistically consistent. Kaplan-Meier showed a significant difference in the cumulative incidence of ureteral stenosis between the two groups.CONCLUSIONS: Preoperative patients with moderate to severe hydronephrosis are more likely to have intraoperative mucosal injury, and the incidence of ureteral stricture is higher after flexible ureteroscopy. Preoperative hydronephrosis is an important predictor of ureteral stricture. Preoperative hydronephrosis is an important predictor of ureteral stricture.

show abstract

Ureteral Strictures Following Ureteroscopic Stone Treatment

Cited by 37 publications

References 22 publications

Ureteroscopy for stone disease in the paediatric population: lessons learned and outcomes in a Nordic setting

Ureteroscopy for stone disease in the paediatric population: lessons learned and outcomes in a Nordic setting

Urolithiasis in Germany: Trends from the National DRG Database

Effect of Preoperative Hydronephrosis on Ureteral Stenosis after Flexible Ureteroscopy: A Propensity Scores Matching Analysis

Contact Info

Product

Resources

About