Investig Clin Urol.  2016 Sep;57(5):343-350. 10.4111/icu.2016.57.5.343.

Clinical factors associated with postoperative hydronephrosis after ureteroscopic lithotripsy

• Kim SW
• Ahn JH
• Yim SU
• Cho YH
• Shin BS
• Chung HS
• Hwang EC
• Yu HS
• Oh KJ
• Kim SO
• Jung SI
• Kang TW
• Kwon DD
• Park K

• KMID: 2427013
• DOI: http://doi.org/10.4111/icu.2016.57.5.343

Abstract

PURPOSE
This study aimed to determine the predictors of ipsilateral hydronephrosis after ureteroscopic lithotripsy for ureteral calculi.
MATERIALS AND METHODS
From January 2010 to December 2014, a total of 204 patients with ureteral calculi who underwent ureteroscopic lithotripsy were reviewed. Patients with lack of clinical data, presence of ureteral rupture, and who underwent simultaneous percutaneous nephrolithotomy (PNL) were excluded. Postoperative hydronephrosis was determined via computed tomographic scan or renal ultrasonography, at 6 months after ureteroscopic lithotripsy. Multivariable analysis was performed to determine clinical factors associated with ipsilateral hydronephrosis.
RESULTS
A total of 137 patients were enrolled in this study. The mean age of the patients was 58.8±14.2 years and the mean stone size was 10.0±4.6 mm. The stone-free rate was 85.4%. Overall, 44 of the 137 patients (32.1%) had postoperative hydronephrosis. Significant differences between the hydronephrosis and nonhydronephrosis groups were noted in terms of stone location, preoperative hydronephrosis, impacted stone, operation time, and ureteral stent duration (all, p < 0.05). On multivariable analysis, increasing preoperative diameter of the hydronephrotic kidney (adjusted odds ratio [OR], 1.21; 95% confidence interval [CI], 1.12-1.31; p=0.001) and impacted stone (adjusted OR, 3.01; 95% CI, 1.15-7.61; p=0.031) independently predicted the occurrence of postoperative hydronpehrosis.
CONCLUSIONS
Large preoperative diameter of the hydronephrotic kidney and presence of impacted stones were associated with hydronephrosis after ureteroscopic stone removal. Therefore, patients with these predictive factors undergo more intensive imaging follow-up in order to prevent renal deterioration due to postoperative hydronephrosis.

Keyword

Hydronephrosis; Ureteral calculi; Ureteroscopy

MeSH Terms

Adult
Aged
Humans
Hydronephrosis/diagnostic imaging/*etiology
Lithotripsy/*adverse effects/methods
Middle Aged
Retrospective Studies
Risk Factors
Tomography, X-Ray Computed
Ultrasonography
Ureteral Calculi/pathology/*surgery
Ureteroscopy/*adverse effects

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