Literature DB >> 25599830

Preoperative factors predicting spontaneous clearance of residual stone fragments after flexible ureteroscopy.

Hiroki Ito1, Shinnosuke Kuroda, Takashi Kawahara, Kazuhide Makiyama, Masahiro Yao, Junichi Matsuzaki.   

Abstract

OBJECTIVE: To investigate factors predicting spontaneous clearance of residual renal fragments after flexible ureteroscopy.
METHODS: Among 546 patients who underwent lithotripsy with flexible ureteroscopy, 81 had residual renal fragments, as determined by kidney-ureter-bladder films on postoperative day 1. The final outcome was determined at 3 months after the last flexible ureteroscopy session using non-contrast computed tomography. Patient characteristics and preoperative factors were analyzed using the unpaired t-test and χ(2)-test. Correlations between the possible predictive factors and the spontaneous clearance of residual renal fragments after flexible ureteroscopy were analyzed using a multivariate logistic regression model with backward selection.
RESULTS: Non-contrast computed tomography at postoperative month 3 showed that 33 cases (40.7%) had spontaneous clearance of residual renal fragments, whereas 48 (59.3%) showed non-clearance. Significant differences were found between these cases in terms of stone number, stone location, presence of lower pole calculi and preoperative stent placement. Multivariate assessment showed that stone number (P = 0.004), presence of lower pole calculi (P = 0.021) and presence of hydronephrosis (P = 0.024) were independent predictors of the spontaneous clearance of residual renal fragments after flexible ureteroscopy.
CONCLUSIONS: Stone number, presence of lower pole calculi and presence of hydronephrosis are independent predictive factors of the spontaneous clearance of residual renal fragments after flexible ureteroscopy.
© 2015 The Japanese Urological Association.

Entities:  

Keywords:  computed tomography; helical; kidney stone; lithotripsy; multivariate analysis; ureteroscopy

Mesh:

Year:  2015        PMID: 25599830     DOI: 10.1111/iju.12690

Source DB:  PubMed          Journal:  Int J Urol        ISSN: 0919-8172            Impact factor:   3.369


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