Department of Urology, HSU Izmir Bozyaka Training and Research Hospital, Izmir, Turkey.
Department of Urology, Amasya University Faculty of Medicine, Amasya, Turkey.
Int Braz J Urol. 2022 Sep-Oct;48(5):817-827. doi: 10.1590/S1677-5538.IBJU.2022.0091.
The present study aimed to investigate the factors of prolonged urinary leakage (PUL) after percutaneous nephrolithotomy (PCNL) and develop a new and simple scoring system to predict it.
We retrospectively reviewed patients with renal stones who underwent PCNL at the University of Health Sciences Izmir Bozyaka Training and Research Hospital between April 2011 and January 2020. The patients were divided into two groups according to the presence of PUL, and their preoperative and perioperative data were compared. A multivariate regression analysis was applied to examine the relationship between perioperative descriptors and PUL, and a nomogram was developed using significant predictors. Then, the individual components of the nomogram were assigned points to form a scoring system.
There were 92 and 840 patients in the groups with and without PUL, respectively. The results of the univariate logistic regression analysis showed that hydronephrosis grade, parenchymal thickness, duration of nephroscopy, and duration of nephrostomy catheter were significantly associated with PUL. Subsequently, a multivariate regression analysis was carried out with these four factors as possible independent risk factors of PUL after PCNL. Based on the results of this analysis, a nomogram prediction model was developed with an area under the curve value of 0.811, which was consequently used to develop a new simple score system consisting of three characteristics: parenchymal thickness (1-5 points), duration of nephroscopy (1-3 points), and hydronephrosis grade (1-3 points).
A novel scoring system is a useful tool for predicting PUL in patients who have undergone percutaneous nephrolithotomy.
本研究旨在探讨经皮肾镜碎石取石术后（PCNL）发生持续性尿漏（PUL）的相关因素，并建立一种新的简单评分系统来预测其发生。
我们回顾性分析了 2011 年 4 月至 2020 年 1 月在伊兹密尔健康科学大学博亚卡培训与研究医院接受 PCNL 治疗的肾结石患者。根据是否发生 PUL 将患者分为两组，并比较了两组患者的术前和围手术期数据。应用多变量回归分析来检验围手术期描述变量与 PUL 之间的关系，并使用显著预测因素建立了列线图。然后，将列线图的各个组成部分赋予分值，形成一个评分系统。
PUL 组和无 PUL 组患者分别有 92 例和 840 例。单因素逻辑回归分析结果显示，肾积水程度、肾实质厚度、输尿管镜操作时间和肾造瘘管留置时间与 PUL 显著相关。随后，对这四个因素作为可能的 PCNL 后 PUL 独立危险因素进行了多因素回归分析。基于该分析结果，建立了一个预测模型，其曲线下面积值为 0.811，随后应用该模型建立了一个包含三个特征的新的简单评分系统：肾实质厚度（1-5 分）、输尿管镜操作时间（1-3 分）和肾积水程度（1-3 分）。
该新型评分系统是一种预测 PCNL 术后发生 PUL 的有用工具。
