Teke Kerem, Çınar Naci Burak, Çınar Önder, Akgül Murat, Başataç Cem, Şimşekoğlu Muhammet Fatih, Çakır Hakan, Özman Oktay, Tuna Mustafa Bilal, Sıddıkoğlu Duygu, Sancak Eyüp Burak, Yazıcı Cenk Murat, Başeskioğlu Barbaros, Akpınar Haluk, Önal Bülent
Department of Urology, Kocaeli University School of Medicine, Umuttepe Campus, Kocaeli, 41380, Turkey.
Department of Urology, Samsun Medicana Hospital, Samsun, Turkey.
Urolithiasis. 2025 Apr 28;53(1):83. doi: 10.1007/s00240-025-01750-z.
It is unclear whether ureteral virginity has an effect on retrograde intrarenal surgery (RIRS). We aimed to evaluate the impact of ureteral virginity on RIRS outcomes in a multicenter study. Data from the RIRSearch study group database were retrospectively reviewed. Patients with a history of endoluminal interventions or extrinsic ureteral surgery were categorized as having a "non-virgin ureter," while those without such histories were classified as "virgin ureters." Case-control matching was performed based on age, gender, uretral access sheath size, and stone characteristics. Demographic, clinical, surgical and complication data were compared after-matching. A total of 894 procedures were included, with 119 (13.3%) involving non-virgin ureters. Pre-matching, the non-virgin ureter group had higher mean age (50.6 ± 13.2 vs. 46.6 ± 13.6 years) and Charlson comorbidity index ≥ 2 (51.3% vs. 40.4%). In addition, number of stones, total-stone volume and rate of multiple stone localization were significantly higher in non-virgin ureter group. Operation time, hospital stay, surgical failure, need for auxiliary treatment, and perioperative complications were significantly higher in non-virgin ureter group (p < 0.05). After case-matching, perioperative complications (18.7% vs. 5.3%), hospital stay (1.54 ± 1.30 vs. 1.18 ± 0.98 days), and auxiliary treatment requirements (20% vs. 8.4%) remained significantly higher in non-virgin ureter group (p < 0.05). There was no significant difference in postoperative complication rates (17.3% vs. 19.8%) or surgical failure rates (36% vs. 26%). Non-virgin ureters were associated with higher perioperative complication rate, longer hospital stays and increased need for auxiliary treatments during RIRS. Patients with non-virgin ureters may be informed about these potential risks before surgery.
输尿管未受侵犯是否会对逆行性肾内手术（RIRS）产生影响尚不清楚。我们旨在通过一项多中心研究评估输尿管未受侵犯对RIRS手术结果的影响。对RIRSearch研究组数据库中的数据进行了回顾性分析。有腔内干预史或输尿管外部手术史的患者被归类为“非处女输尿管”，而没有此类病史的患者则被归类为“处女输尿管”。根据年龄、性别、输尿管入路鞘尺寸和结石特征进行病例对照匹配。匹配后比较人口统计学、临床、手术和并发症数据。共纳入894例手术，其中119例（13.3%）涉及非处女输尿管。匹配前，非处女输尿管组的平均年龄较高（50.6±13.2岁对46.6±13.6岁），Charlson合并症指数≥2的比例较高（51.3%对40.4%）。此外，非处女输尿管组的结石数量、结石总体积和多发结石定位率显著更高。非处女输尿管组的手术时间、住院时间、手术失败率、辅助治疗需求和围手术期并发症显著更高（p<0.05）。病例匹配后，非处女输尿管组的围手术期并发症（18.7%对5.3%）、住院时间（1.54±1.30天对1.18±0.98天）和辅助治疗需求（20%对8.4%）仍然显著更高（p<0.05）。术后并发症发生率（17.3%对19.8%）或手术失败率（36%对26%）无显著差异。非处女输尿管与RIRS期间较高的围手术期并发症发生率、更长的住院时间和增加的辅助治疗需求相关。对于有非处女输尿管的患者，可在手术前告知其这些潜在风险。
