PROSPECTIVE EVALUATION OF ENDOSCOPIC FINDINGS AND ANALYSES OF THE RISK FACTORS FOR URETERAL CHANGES DURING URSL

You have accessJournal of UrologyStone Disease: Surgical Therapy II (PD07)1 Apr 2020PD07-11 PROSPECTIVE EVALUATION OF ENDOSCOPIC FINDINGS AND ANALYSES OF THE RISK FACTORS FOR URETERAL CHANGES DURING URSL Shuzo Hamamoto*, Shinsuke Okada, Takaaki Inoue, Tomoki Okada, Ryosuke Chaya, Kengo Kawase, Kazumi Taguchi, Atsushi Okada, Hiroyasu Miura, Tadashi Matsuda, and Takahiro Tasui Shuzo Hamamoto*Shuzo Hamamoto* More articles by this author , Shinsuke OkadaShinsuke Okada More articles by this author , Takaaki InoueTakaaki Inoue More articles by this author , Tomoki OkadaTomoki Okada More articles by this author , Ryosuke ChayaRyosuke Chaya More articles by this author , Kengo KawaseKengo Kawase More articles by this author , Kazumi TaguchiKazumi Taguchi More articles by this author , Atsushi OkadaAtsushi Okada More articles by this author , Hiroyasu MiuraHiroyasu Miura More articles by this author , Tadashi MatsudaTadashi Matsuda More articles by this author , and Takahiro TasuiTakahiro Tasui More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000834.011AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Difficulty performing ureteroscopic lithotripsy (URSL) depends on endoscopic findings (EFs) surrounding calculi. We established a classification of EFs and analyzed the risk factors for ureteral changes. METHODS: This was a multicenter prospective cohort study of 832 patients who underwent ureteroscopic lithotripsy registered in the SMART Study Group from January 2014 to February 2017; 185 cases of single ureteral stones were analyzed. We evaluated EFs (edema, polyps, stone adhesion, and distal ureteric tightness) based on the SMART classification (Figure1). RESULTS: Surgical duration and ureteral damage during URSL were significantly correlated with EFs grade. Multivariate analysis revealed that edema was affected by stone size (odds ratio, 9.50; p<0.001), and stone adhesion was strongly affected by hydronephrosis grade (odds ratio, 12.4; p=0.022) and the interval before surgery (odds ratio, 1.10; p=0.012) (Table 1). The cutoff value for stone adhesion was 98 days, with a predictive accuracy of 0.78. The risk factors for distal ureteric tightness were age (odds ratio, 0.96; p=0.004) and early intervention (odds ratio, 0.90; p=0.023). The cutoff value was 34 days, with a predictive accuracy of 0.72. CONCLUSIONS: We first defined UFs during URSL and used the SMART classification to predict surgical difficulty worldwide. Retention time of a ureteral stone and the presence of hydronephrosis were risk factors for stone adhesion. There is a relationship between early intervention and patient age with DUT. URSL should be performed as soon as possible within one month of symptom onset. However, for suspected stone impaction cases with more than 3 months until symptom onset, alternative procedures and detailed informed consent should be planned in advance. Source of Funding: No © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e165-e165 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shuzo Hamamoto* More articles by this author Shinsuke Okada More articles by this author Takaaki Inoue More articles by this author Tomoki Okada More articles by this author Ryosuke Chaya More articles by this author Kengo Kawase More articles by this author Kazumi Taguchi More articles by this author Atsushi Okada More articles by this author Hiroyasu Miura More articles by this author Tadashi Matsuda More articles by this author Takahiro Tasui More articles by this author Expand All Advertisement PDF downloadLoading ...