输尿管膀胱连接处的输尿管壁厚度是预测输尿管膀胱连接处结石药物排石治疗效果的重要因素。

Ureteral wall thickness at the ureterovesical junction as a significant factor in predicting medical expulsive therapy of ureterovesical junction stones.

作者信息

Yang Tiancan, Ji Jian, Wang Yafei, Gao Xiaowen, Lei Lingmin, Chen Lvyang, Fan Shicheng, Wu Zhida, Pu Wei, Shang Yunbo

机构信息

Department of Urology, the Second Affiliated Hospital of Dali University (the Third People's Hospital of Yunnan Province), Kunming, 650011, China.

Department of Urology, the Third People's Hospital of Yunnan Province, No. 292 Beijing Road, Guandu District, Kunming, 650011, China.

出版信息

BMC Urol. 2025 Aug 23;25(1):215. doi: 10.1186/s12894-025-01890-9.

DOI:10.1186/s12894-025-01890-9

PMID:40849490

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12374378/

Abstract

BACKGROUND

To evaluate ureteral wall thickness (UWT) at the ureterovesical junction (UVJ) measured by ultrasound for predicting spontaneous passage (SP) of uncomplicated UVJ stones.

PATIENTS AND METHODS

We retrospectively reviewed 170 patients ≥ 18 years old, and size ≤ 10 mm of single UVJ stone, who were examined and treated in the Third People's Hospital of Yunnan Province from January 2020 to January 2024. The analysis included the size of the stones, the maximum UWT at the stone site measured by ultrasound, the degree of hydronephrosis, and the time of stone removal.According to the different results after four weeks of medical expulsive therapy (MET), the patients were separated into two categories: Stone-passing group (SPG) and non-stone-passing group (NSPG). Univariate and multivariate logistic regression analysis were utilised to evaluate the clinical predictors of MET.The receiver operating characteristic (ROC) curve was employed to evaluate the accuracy of the UWT at the UVJ in predicting successful MET.

RESULTS

The SPG comprised 112 cases (65.9%), while the NSPG consisted of 58 cases (34.2%). Univariate analysis, employing both the chi-square test and the Mann-Whitney U test, revealed that gender, age, stone side and degree of hydronephrosis were not statistically significant. However, stone size and UWT were found to be influencing factors in regard to stone removal. Binary logistic regression analysis demonstrated that UWT and size were independent influencing factor of MET. The ROC analysis indicated that 3.705 mm was the ideal threshold for UWT, with sensitivity and specificity levels of 72.4% and 68.7%, with an area under the ROC curve (AUC) of 0.737.

CONCLUSIONS

The UWT at the UVJ has a high predictive value for the MET of stones at this position, thus avoiding the adverse consequences of delayed stone discharge caused by unnecessary surgical operation and MET.

摘要

背景

评估超声测量输尿管膀胱连接部（UVJ）的输尿管壁厚度（UWT）以预测单纯性UVJ结石的自然排出（SP）情况。

患者与方法

我们回顾性分析了2020年1月至2024年1月在云南省第三人民医院接受检查和治疗的170例年龄≥18岁、单颗UVJ结石大小≤10 mm的患者。分析内容包括结石大小、超声测量结石部位的最大UWT、肾积水程度以及结石排出时间。根据药物排石治疗（MET）四周后的不同结果，将患者分为两组：结石排出组（SPG）和非结石排出组（NSPG）。采用单因素和多因素逻辑回归分析来评估MET的临床预测因素。使用受试者工作特征（ROC）曲线评估UVJ处UWT预测MET成功的准确性。

结果

SPG组有112例（65.9%），NSPG组有58例（34.2%）。采用卡方检验和曼 - 惠特尼U检验的单因素分析显示，性别、年龄、结石侧别和肾积水程度无统计学意义。然而，发现结石大小和UWT是影响结石排出的因素。二元逻辑回归分析表明，UWT和结石大小是MET的独立影响因素。ROC分析表明，UWT的理想阈值为3.705 mm，敏感性和特异性分别为72.4%和68.7%，ROC曲线下面积（AUC）为0.737。