Endourology
Primary ureteroscopic failure : identification of the predictive factors
2019 Volume 32 Issue 1 Pages 98-105
Details
2019 Volume 32 Issue 1 Pages 98-105
Purpose : Primary ureteroscopic surgery for kidney or ureteral calculi occasionally encounters difficulty with insertion of the ureteroscope. These patients need a second procedure after stenting. We aim to define contemporary failure rate of primary ureteroscopy (URS) and identify predictive factors for access failure.
Material and Methods : We conducted a retrospective review of 845 unstented patients undergoing primary URS form February 2010 to April 2018. The primary outcome was gaining access to the unstented ureter.
Results : The failure rate for accessing the unstented ureter was 9.9% (84/845). There were no difference in the median age, gender, height, weight, and body mass index with access vs failure. On multivariable logistic regression, stone location (kidney > proximal ureter > middle & distal ureter), small diameter, no previous urolithiasis history, middle or severe hydronephrosis and emergent surgery revealed independent and significant predictors of failure. The stone free rate by re-URS after stenting was 84.6% (55/65).
Conclusions : A certain overall rate of ureteral access failure in unstented patients is shown. This study provides the information that will help urologists counsel their patients preoperatively regarding their likelihood of failing primary URS necessitating a second procedure.
