Queen Alexandra Hospital, Portsmouth Hospitals University NHS Trsut, Portsmouth, UK.
Inverclyde Royal Hospital, Greenock, UK.
Scand J Urol. 2021 Oct;55(5):394-398. doi: 10.1080/21681805.2021.1953581. Epub 2021 Aug 6.
Ureteric stricture is a potential complication of impacted ureteric stones. This study investigates surgical and radiological factors that could predict ureteric stricture formation after ureteroscopic treatment of impacted ureteric stones.
Intraoperative and radiological data for patients who underwent ureteroscopic treatment of ureteric stones impaction over a 5-year period were reviewed retrospectively. Patients who had previous ureteroscopic treatment or strictures were excluded.
Between January 2014 and May 2019, 1,340 patients presented as emergency renal colic secondary to ureteric stones. A total of 297 ureteroscopy procedures were performed for impacted calculi. The mean age was 53 years. The stricture rate was 3.3%. Analysis of radiological and surgical factors revealed that the degree of hydronephrosis, residual fragments and intraoperative ureteric injury were significant predictors for stricture formation ( = 0.018, 0.01 and 0.02, OR = 10, 47 and 1776, respectively). None of the other factors significantly predicted ureteric stricture formation.
Our study found the presence of severe hydronephrosis, residual stone fragments after surgery and intraoperative ureteric injury are significant predictive factors for ureteric stricture formation. The high-risk patients should be monitored with routine postoperative renal ultrasound.
输尿管狭窄是嵌顿性输尿管结石的潜在并发症。本研究探讨了经输尿管镜治疗嵌顿性输尿管结石后可能导致输尿管狭窄形成的手术和影像学因素。
回顾性分析了 5 年内因嵌顿性输尿管结石接受输尿管镜治疗的患者的术中及影像学资料。排除了既往有输尿管镜治疗或狭窄的患者。
2014 年 1 月至 2019 年 5 月，1340 例患者因输尿管结石急诊肾绞痛就诊。共对 297 例嵌顿性结石患者行输尿管镜治疗。患者平均年龄为 53 岁。狭窄发生率为 3.3%。对影像学和手术因素进行分析，发现肾积水程度、残石碎片和术中输尿管损伤是狭窄形成的显著预测因素（ = 0.018、0.01 和 0.02，OR = 10、47 和 1776）。其他因素均无显著预测输尿管狭窄形成的作用。
本研究发现严重肾积水、术后残石碎片和术中输尿管损伤是输尿管狭窄形成的显著预测因素。高危患者应常规行术后肾脏超声检查。
