Department of Urology, Liyang People's Hospital, 213300 Liyang, Jiangsu, China.
Arch Esp Urol. 2024 Aug;77(7):805-810. doi: 10.56434/j.arch.esp.urol.20247707.112.
Currently, the factors influencing poor drainage of ureteral stents after radical cystectomy with cutaneous ureterostomy are still unclear. Therefore, the aim of this study was to determine the risk factors for poor drainage of ureteral stents after radical cystectomy with cutaneous ureterostomy and to provide evidence for the prevention of this complication.
This retrospective study included 86 patients who underwent periodic replacement of ureteral stents following radical cystectomy with cutaneous ureterostomy between October 2017 and March 2024. The general data and related indicators of the patients were collected, the risk factors were identified through univariate and multivariate logistic regression analyses, and corresponding interventions were proposed.
Among the 86 patients, 26 had poor drainage of ureteral stents, with an incidence rate of 30.23%, and no serious consequences occurred after timely and effective treatment. Univariate and multivariate logistic regression analyses revealed that body mass index (BMI) ( = 0.003, odds ratio (OR) = 2.909, 95% CI: 1.435-5.898), diabetes mellitus ( = 0.012, OR = 14.073, 95% CI: 1.770-111.889), urinary tract infection ( = 0.004, OR = 16.792, 95% CI: 2.402-117.411), and foreign body blockage ( = 0.048, OR = 5.277, 95% CI: 1.012-27.512) were independent risk factors for poor drainage of ureteral stents.
The incidence of poor drainage of ureteral stents after radical cystectomy with cutaneous ureterostomy is relatively high. Maintenance of a healthy weight, strict management of blood glucose levels, active prevention of urinary tract infections, and timely detection and removal of small foreign bodies that may be present are essential to prevent this complication.
目前，根治性膀胱切除术加皮输尿管造口术后输尿管支架引流不畅的影响因素仍不清楚。因此，本研究旨在确定根治性膀胱切除术加皮输尿管造口术后输尿管支架引流不畅的危险因素，为预防该并发症提供依据。
本回顾性研究纳入 2017 年 10 月至 2024 年 3 月期间定期更换输尿管支架的 86 例根治性膀胱切除术加皮输尿管造口术后患者。收集患者的一般资料和相关指标，通过单因素和多因素 logistic 回归分析确定危险因素，并提出相应的干预措施。
86 例患者中，26 例出现输尿管支架引流不畅，发生率为 30.23%，经及时有效治疗后无严重后果。单因素和多因素 logistic 回归分析显示，体质量指数（BMI）（ = 0.003，比值比（OR）= 2.909，95%可信区间：1.435-5.898）、糖尿病（ = 0.012，OR = 14.073，95%可信区间：1.770-111.889）、尿路感染（ = 0.004，OR = 16.792，95%可信区间：2.402-117.411）和异物阻塞（ = 0.048，OR = 5.277，95%可信区间：1.012-27.512）是输尿管支架引流不畅的独立危险因素。
根治性膀胱切除术加皮输尿管造口术后输尿管支架引流不畅的发生率相对较高。保持健康体重、严格控制血糖水平、积极预防尿路感染以及及时发现和清除可能存在的小异物，对于预防该并发症至关重要。
