Incidence and Predictors for Ipsilateral Hydronephrosis Following Ureteroscopic Lithotripsy

Meredith L. Barbour, Jay Raman

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective To review our experience in using ureteroscopy (URS) with lithotripsy for renal or ureteral calculi to determine the incidence and predictors of postprocedural ipsilateral hydronephrosis. Patients and Methods Records of 324 URS cases for renal or ureteral calculi with imaging performed 4-12 weeks postprocedure were reviewed. Ipsilateral hydronephrosis was determined by computed tomography scan or renal ultrasound. Univariate and multivariate analyses determined the factors associated with hydronephrosis. Results 176 men and 148 women with a median age of 50 years were included. Median stone size was 6 mm and operative duration was 60 minutes; 30% of patients had multiple calculi; and 35% had undergone a prior ipsilateral URS. Overall, 49 of 324 patients (15%) had evidence of hydronephrosis, with 65% of these patients having symptoms and 40% requiring ancillary procedures. On multivariate analysis, increasing stone diameter (odds ratio [OR] 8.9, 95% confidence interval [CI] 1.9-23.8, P =.03), prior ipsilateral URS (OR 7.7, 95% CI 1.8-28.2, P =.006), longer operative duration (OR 6.5, 95% CI 1.8-16.3, P =.02), and renal colic symptoms (OR 48.3, 95% CI 14.7-71.4, P <.001) independently predicted hydronephrosis. Conversely, other factors including stone impaction at procedure, ureteral dilation, use of an access sheath, intraoperative perforation, or use of a stent did not associate with ipsilateral hydronephrosis. Conclusion In this contemporary cohort study, 15% of patients undergoing URS had evidence of ipsilateral hydronephrosis. Larger stone size, longer OR duration, prior ipsilateral URS, and recurrent colic were associated with an increased likelihood for this observation. Patients and stone cases with such characteristics likely warrant imaging modalities beyond plain radiography.

Original languageEnglish (US)
Pages (from-to)465-471
Number of pages7
JournalUrology
Volume86
Issue number3
DOIs
StatePublished - Sep 1 2015

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Ureteroscopy
Lithotripsy
Hydronephrosis
Incidence
Odds Ratio
Confidence Intervals
Ureteral Calculi
Kidney Calculi
Multivariate Analysis
Renal Colic
Colic
Calculi
Radiography
Stents
Dilatation
Cohort Studies
Tomography
Kidney

All Science Journal Classification (ASJC) codes

  • Urology
  • Medicine(all)

Cite this

@article{511792b5793647ae8be6aa91178399f6,
title = "Incidence and Predictors for Ipsilateral Hydronephrosis Following Ureteroscopic Lithotripsy",
abstract = "Objective To review our experience in using ureteroscopy (URS) with lithotripsy for renal or ureteral calculi to determine the incidence and predictors of postprocedural ipsilateral hydronephrosis. Patients and Methods Records of 324 URS cases for renal or ureteral calculi with imaging performed 4-12 weeks postprocedure were reviewed. Ipsilateral hydronephrosis was determined by computed tomography scan or renal ultrasound. Univariate and multivariate analyses determined the factors associated with hydronephrosis. Results 176 men and 148 women with a median age of 50 years were included. Median stone size was 6 mm and operative duration was 60 minutes; 30{\%} of patients had multiple calculi; and 35{\%} had undergone a prior ipsilateral URS. Overall, 49 of 324 patients (15{\%}) had evidence of hydronephrosis, with 65{\%} of these patients having symptoms and 40{\%} requiring ancillary procedures. On multivariate analysis, increasing stone diameter (odds ratio [OR] 8.9, 95{\%} confidence interval [CI] 1.9-23.8, P =.03), prior ipsilateral URS (OR 7.7, 95{\%} CI 1.8-28.2, P =.006), longer operative duration (OR 6.5, 95{\%} CI 1.8-16.3, P =.02), and renal colic symptoms (OR 48.3, 95{\%} CI 14.7-71.4, P <.001) independently predicted hydronephrosis. Conversely, other factors including stone impaction at procedure, ureteral dilation, use of an access sheath, intraoperative perforation, or use of a stent did not associate with ipsilateral hydronephrosis. Conclusion In this contemporary cohort study, 15{\%} of patients undergoing URS had evidence of ipsilateral hydronephrosis. Larger stone size, longer OR duration, prior ipsilateral URS, and recurrent colic were associated with an increased likelihood for this observation. Patients and stone cases with such characteristics likely warrant imaging modalities beyond plain radiography.",
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Incidence and Predictors for Ipsilateral Hydronephrosis Following Ureteroscopic Lithotripsy. / Barbour, Meredith L.; Raman, Jay.

In: Urology, Vol. 86, No. 3, 01.09.2015, p. 465-471.

Research output: Contribution to journalArticle

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AU - Barbour, Meredith L.

AU - Raman, Jay

PY - 2015/9/1

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N2 - Objective To review our experience in using ureteroscopy (URS) with lithotripsy for renal or ureteral calculi to determine the incidence and predictors of postprocedural ipsilateral hydronephrosis. Patients and Methods Records of 324 URS cases for renal or ureteral calculi with imaging performed 4-12 weeks postprocedure were reviewed. Ipsilateral hydronephrosis was determined by computed tomography scan or renal ultrasound. Univariate and multivariate analyses determined the factors associated with hydronephrosis. Results 176 men and 148 women with a median age of 50 years were included. Median stone size was 6 mm and operative duration was 60 minutes; 30% of patients had multiple calculi; and 35% had undergone a prior ipsilateral URS. Overall, 49 of 324 patients (15%) had evidence of hydronephrosis, with 65% of these patients having symptoms and 40% requiring ancillary procedures. On multivariate analysis, increasing stone diameter (odds ratio [OR] 8.9, 95% confidence interval [CI] 1.9-23.8, P =.03), prior ipsilateral URS (OR 7.7, 95% CI 1.8-28.2, P =.006), longer operative duration (OR 6.5, 95% CI 1.8-16.3, P =.02), and renal colic symptoms (OR 48.3, 95% CI 14.7-71.4, P <.001) independently predicted hydronephrosis. Conversely, other factors including stone impaction at procedure, ureteral dilation, use of an access sheath, intraoperative perforation, or use of a stent did not associate with ipsilateral hydronephrosis. Conclusion In this contemporary cohort study, 15% of patients undergoing URS had evidence of ipsilateral hydronephrosis. Larger stone size, longer OR duration, prior ipsilateral URS, and recurrent colic were associated with an increased likelihood for this observation. Patients and stone cases with such characteristics likely warrant imaging modalities beyond plain radiography.

AB - Objective To review our experience in using ureteroscopy (URS) with lithotripsy for renal or ureteral calculi to determine the incidence and predictors of postprocedural ipsilateral hydronephrosis. Patients and Methods Records of 324 URS cases for renal or ureteral calculi with imaging performed 4-12 weeks postprocedure were reviewed. Ipsilateral hydronephrosis was determined by computed tomography scan or renal ultrasound. Univariate and multivariate analyses determined the factors associated with hydronephrosis. Results 176 men and 148 women with a median age of 50 years were included. Median stone size was 6 mm and operative duration was 60 minutes; 30% of patients had multiple calculi; and 35% had undergone a prior ipsilateral URS. Overall, 49 of 324 patients (15%) had evidence of hydronephrosis, with 65% of these patients having symptoms and 40% requiring ancillary procedures. On multivariate analysis, increasing stone diameter (odds ratio [OR] 8.9, 95% confidence interval [CI] 1.9-23.8, P =.03), prior ipsilateral URS (OR 7.7, 95% CI 1.8-28.2, P =.006), longer operative duration (OR 6.5, 95% CI 1.8-16.3, P =.02), and renal colic symptoms (OR 48.3, 95% CI 14.7-71.4, P <.001) independently predicted hydronephrosis. Conversely, other factors including stone impaction at procedure, ureteral dilation, use of an access sheath, intraoperative perforation, or use of a stent did not associate with ipsilateral hydronephrosis. Conclusion In this contemporary cohort study, 15% of patients undergoing URS had evidence of ipsilateral hydronephrosis. Larger stone size, longer OR duration, prior ipsilateral URS, and recurrent colic were associated with an increased likelihood for this observation. Patients and stone cases with such characteristics likely warrant imaging modalities beyond plain radiography.

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