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Factors affecting the outcome of emergency ureteroscopy in the management of ureteric stones: uni- and multi- variate analysis

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Factors affecting the outcome of emergency ureteroscopy in the management of ureteric stones: Uni- and multi variate

 

analysis.

 

INTRODUCTION AND OBJECTIVES: To evaluate the results of the emergency ureteroscopy (URS) in the treatment of

ureteric stones and to identify predictors of failure.

METHODS: During a period of 07 years, from 2008 to 2016,

retrograde rigid URS have been performed in 150 patients, related to distal ureteral calculi. Were treated in the emergency by

ureteroscopy, (mean age: 41,3 years, male: 115). We used a rigid 8 CH URS and lithoclast disintegration device. At the end of the

procedure, Ureteral stenting was performed in all cases. Treatment success was defined by the desperate of the pain associated

with the elimination stones. We made an analytical study (uni- and multi-variate) to identify predictors of failure of the emergency

URS.

RESULTS: The average size of the stones was 8,5 mm (range, 6 to 15 mm). The

site of ureteric stones was pelvic in all cases. The overall success rate by renal unit was 90%. The univariate analysis showed a

statistical correlation between the failure of URS and the following variables: the size of stone (p =0,001), density of calculi (p=0,05)

and degree of pelvicalyceal dilatation (p=0,01). The multivariate logistic regression analysis retained: the stone size (p = 0.01) and

the degree of pelvicalyceal dilatation (p = 0.04) as independent predictive factors of failure of emergency URS. Adverse post

ureteroscopy effects were frequent (moderate pelvic pain : 100%, hematuria 60 %).Their intensity was always minimal to moderate.

Complications were rare. It was minor complications in all cases ( mucosal injury : 1 case; cracking meatus: 3 cases ) not requiring a

supplementary procedure

CONCLUSIONS: The predictors of failure of the emergency URS are: stone diameter (greater than 11 mm), and marked

cavity dilatation.

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