ABSTRACT
Objetivo: Determinar la relación entre la impactación de los cálculos ureterales y la formación de estenosis ureterales y los factores asociados. Material y métodos Se analizaron retrospectivamente los registros médicos de todos los pacientes sometidos a cirugía endoscópica por cálculos ureterales impactados en 3 hospitales universitarios de Turquía, Reino Unido y España entre junio de 2019 y enero de 2022. Los parámetros examinados incluyeron los datos demográficos del paciente, lateralidad, tamaño y localización del cálculo, tiempo entre el inicio de los síntomas y la cirugía, tipo de ureteroscopia (rígida/flexible), presencia de nefrostomía o catéter doble J antes de la ureteroscopia, complicaciones intraoperatorias (avulsión/perforación), estado libre de cálculos, número de procedimientos necesarios para obtener un estado libre de cálculos y los resultados de las pruebas de imagen postoperatorias. Resultados Un total de 41 pacientes, 25 varones y 16 mujeres, de 3 instituciones fueron incluidos en el estudio. La edad media de los pacientes era de 48,2±13,5 años. La mediana del diámetro mayor de los cálculos fue de 9mm (RIC: 8mm). Catorce (34,1%) pacientes desarrollaron estenosis ureteral después de la ureteroscopia. No hubo diferencias entre los pacientes que desarrollaron estenosis ureteral y los que no la desarrollaron en cuanto a la lateralidad, la localización, la hidronefrosis y la multiplicidad de los cálculos (p=0,58, p=0,14, p=0,79 y p=0,31, respectivamente). Los pacientes que desarrollaron estenosis ureteral presentaron una tasa más elevada de derivación urinaria preoperatoria, como nefrostomía o catéter doble J (p=0,000). Conclusión La interrupción del paso de la orina por el uréter mediante derivación urinaria con nefrostomía o catéter doble J antes de la cirugía de cálculos ureterales podría favorecer la formación de estenosis ureteral en el postoperatorio. (AU)
Objective: To determine the relation between ureteral stone impaction and ureteral stricture formation and associated factors. Material and methods We retrospectively analyzed the medical records of all patients who underwent endoscopic ureteral stone surgery for impacted ureteral stone at 3 academic institutions in Turkey, United Kingdom and Spain between June 2019 and January 2022. Examined parameters included patient demographics, stone side, size and localization, time between initiation of symptoms and surgery, type of ureteroscopy (rigid/flexible), presence of nephrostomy or double-J stent prior to ureteroscopy, intraoperative complications (avulsion/perforation), stone-free status, number of procedures required for stone-free status, postoperative imaging results. Results A total of 41 patients whom 25 were male and 16 were female, from 3 institutions were included the study. The mean age of the patients was 48.2±13.5 years. The median largest diameter of the stones was 9mm (IQR: 8mm). Fourteen (34.1%) patients developed ureteral strictures following ureteroscopy. There was no difference between patients who developed ureteral strictures and patients who did not developed strictures in terms of stone laterality, stone location, hydronephrosis and multiplicity (p=0.58, p=0.14, p=0.79 and p=0.31, respectively). Patients who developed ureteral strictures had a higher rate of preoperative urinary diversion such as nephrostomy or double-J stent (p=0.000). Conclusion Interruption of urine passage through ureter via urinary diversion such as nephrostomy or double-J stent prior to ureteral stone surgery might lead ureteral stricture formation in the postoperative period. (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Ureteral Calculi/complications , Ureteral Calculi/therapy , Urethral Stricture , Urolithiasis/therapy , Retrospective Studies , Turkey , United Kingdom , SpainABSTRACT
Standardized structured radiological reporting (SSRB) has been promoted in recent years. The aims of SSRB include that reports be complete, clear, understandable, and stringent. Repetitions or superfluous content should be avoided. In addition, there are advantages in the presentation of chronological sequences, tracking and correlations with structured findings from other disciplines and also the use of artificial intelligence (AI)-based methods. The development of the presented template for SSRB of native computed tomography for urinary stones followed the "process for the creation of quality-assured and consensus-based report templates as well as subsequent continuous quality control and updating" proposed by the German Radiological Society (DRG). This includes several stages of drafts, consensus meetings and further developments. The final version was published on the DRG website ( www.befundung.drg.de ). The template will be checked annually by the steering group and adjusted as necessary. The template contains 6 organ domains (e.g., right kidney) for which entries can be made for a total of 21 different items, mostly with selection windows. If "no evidence of stones" is selected for an organ in the first query, the query automatically jumps to the next organ, so that the processing can be processed very quickly despite the potentially high total number of individual queries for all organs. The German, European, and North American Radiological Societies perceive the establishment of a standardized structured diagnosis of tomographic imaging methods not only in oncological radiology as one of the current central tasks. With the present template for the description of computed tomographic findings for urinary stone diagnostics, we are presenting the first version of a urological template. Further templates for urological diseases are to follow.
Subject(s)
Radiology , Urinary Calculi , Urolithiasis , Urology , Humans , Artificial Intelligence , Urolithiasis/diagnosis , Tomography, X-Ray Computed/methodsABSTRACT
OBJECTIVE: To determine the relation between ureteral stone impaction and ureteral stricture formation and associated factors. MATERIAL AND METHODS: We retrospectively analyzed the medical records of all patients who underwent endoscopic ureteral stone surgery for impacted ureteral stone at three academic institutions in Turkey, United Kingdom and Spain between June 2019 and January 2022. Examined parameters included patient demographics, stone side, size and localization, time between initiation of symptoms and surgery, type of ureteroscopy (rigid/flexible), presence of nephrostomy or double-J stent prior to URS, intraoperative complications (avulsion/perforation, stone-free status, number of procedures required for stone-free status, postoperative imaging results. RESULTS: A total of 41 patients whom 25 were male and 16 were female, from 3 institutions were included the study. The mean age of the patients was 48.2⯱â¯13.5 years. The median largest diameter of the stones was 9â¯mm (IQR: 8â¯mm). Total 14 (34.1%) patients developed ureteral strictures following ureteroscopy. There was no difference between patients who developed ureteral strictures and patients who did not developed strictures in terms of stone laterality, stone location, hydronephrosis and multiplicity, pâ¯=â¯0.58, pâ¯=â¯0.14, pâ¯=â¯0.79 and pâ¯=â¯0.31. Patients who developed ureteral strictures had a higher rate of preoperative urinary diversion such as nephrostomy or DJS, pâ¯=â¯0.000. CONCLUSION: Interruption of urine passage through ureter via urinary diversion such as nephrostomy or DJS stent prior to ureteral stone surgery might lead ureteral stricture formation in the postoperative period.
