Prospective evaluation and classification of endoscopic findings for ureteral calculi

Abstract Difficulty in performing ureteroscopic lithotripsy (URSL) depends on endoscopic findings surrounding calculi. In this multicentre prospective cohort study of 185 patients with a single ureteral stone who underwent ureteroscopic lithotripsy registered in the SMART study between January 2014...

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Autores principales:	Shuzo Hamamoto, Shinsuke Okada, Takaaki Inoue, Teruaki Sugino, Rei Unno, Kazumi Taguchi, Ryosuke Ando, Atsushi Okada, Hiroyasu Miura, Tadashi Matsuda, Takahiro Yasui
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a6b4178eb23741a7a1765510043fe34c
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spelling	oai:doaj.org-article:a6b4178eb23741a7a1765510043fe34c2021-12-02T16:26:21ZProspective evaluation and classification of endoscopic findings for ureteral calculi10.1038/s41598-020-69158-w2045-2322https://doaj.org/article/a6b4178eb23741a7a1765510043fe34c2020-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-69158-whttps://doaj.org/toc/2045-2322Abstract Difficulty in performing ureteroscopic lithotripsy (URSL) depends on endoscopic findings surrounding calculi. In this multicentre prospective cohort study of 185 patients with a single ureteral stone who underwent ureteroscopic lithotripsy registered in the SMART study between January 2014 and February 2017, we established a classification of endoscopic findings and analysed risk factors for ureteral changes. We evaluated endoscopic findings (oedema, polyps, ureteral mucosa-stone adherence, and distal ureteric tightness) based on the SMART classification. Operative time and ureteral injuries were significantly correlated with endoscopic finding grades. Multivariate analyses revealed that mucosa-stone adherence (MSA) was strongly affected by hydronephrosis grade (odds ratio, 12.4; p = 0.022) and the interval before surgery (odds ratio, 1.10; p = 0.012). The cutoff value for MSA was 98 days, with a predictive accuracy of 0.78. Risk factors for distal ureteric tightness were age (odds ratio, 0.96; p = 0.004) and early intervention (odds ratio, 0.90; p = 0.023). The cutoff value was 34 days, with a predictive accuracy of 0.72. In conclusion, appropriate intervention around 34 days (limited to 98 days) after symptom onset is necessary for treating ureteral calculi. Even if intervention passed 98 days post-symptom onset, staged URSL, alternative procedures, and detailed informed consent should be planned in advance, assuming strong MSA.Shuzo HamamotoShinsuke OkadaTakaaki InoueTeruaki SuginoRei UnnoKazumi TaguchiRyosuke AndoAtsushi OkadaHiroyasu MiuraTadashi MatsudaTakahiro YasuiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-10 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Shuzo Hamamoto Shinsuke Okada Takaaki Inoue Teruaki Sugino Rei Unno Kazumi Taguchi Ryosuke Ando Atsushi Okada Hiroyasu Miura Tadashi Matsuda Takahiro Yasui Prospective evaluation and classification of endoscopic findings for ureteral calculi
description	Abstract Difficulty in performing ureteroscopic lithotripsy (URSL) depends on endoscopic findings surrounding calculi. In this multicentre prospective cohort study of 185 patients with a single ureteral stone who underwent ureteroscopic lithotripsy registered in the SMART study between January 2014 and February 2017, we established a classification of endoscopic findings and analysed risk factors for ureteral changes. We evaluated endoscopic findings (oedema, polyps, ureteral mucosa-stone adherence, and distal ureteric tightness) based on the SMART classification. Operative time and ureteral injuries were significantly correlated with endoscopic finding grades. Multivariate analyses revealed that mucosa-stone adherence (MSA) was strongly affected by hydronephrosis grade (odds ratio, 12.4; p = 0.022) and the interval before surgery (odds ratio, 1.10; p = 0.012). The cutoff value for MSA was 98 days, with a predictive accuracy of 0.78. Risk factors for distal ureteric tightness were age (odds ratio, 0.96; p = 0.004) and early intervention (odds ratio, 0.90; p = 0.023). The cutoff value was 34 days, with a predictive accuracy of 0.72. In conclusion, appropriate intervention around 34 days (limited to 98 days) after symptom onset is necessary for treating ureteral calculi. Even if intervention passed 98 days post-symptom onset, staged URSL, alternative procedures, and detailed informed consent should be planned in advance, assuming strong MSA.
format	article
author	Shuzo Hamamoto Shinsuke Okada Takaaki Inoue Teruaki Sugino Rei Unno Kazumi Taguchi Ryosuke Ando Atsushi Okada Hiroyasu Miura Tadashi Matsuda Takahiro Yasui
author_facet	Shuzo Hamamoto Shinsuke Okada Takaaki Inoue Teruaki Sugino Rei Unno Kazumi Taguchi Ryosuke Ando Atsushi Okada Hiroyasu Miura Tadashi Matsuda Takahiro Yasui
author_sort	Shuzo Hamamoto
title	Prospective evaluation and classification of endoscopic findings for ureteral calculi
title_short	Prospective evaluation and classification of endoscopic findings for ureteral calculi
title_full	Prospective evaluation and classification of endoscopic findings for ureteral calculi
title_fullStr	Prospective evaluation and classification of endoscopic findings for ureteral calculi
title_full_unstemmed	Prospective evaluation and classification of endoscopic findings for ureteral calculi
title_sort	prospective evaluation and classification of endoscopic findings for ureteral calculi
publisher	Nature Portfolio
publishDate	2020
url	https://doaj.org/article/a6b4178eb23741a7a1765510043fe34c
work_keys_str_mv	AT shuzohamamoto prospectiveevaluationandclassificationofendoscopicfindingsforureteralcalculi AT shinsukeokada prospectiveevaluationandclassificationofendoscopicfindingsforureteralcalculi AT takaakiinoue prospectiveevaluationandclassificationofendoscopicfindingsforureteralcalculi AT teruakisugino prospectiveevaluationandclassificationofendoscopicfindingsforureteralcalculi AT reiunno prospectiveevaluationandclassificationofendoscopicfindingsforureteralcalculi AT kazumitaguchi prospectiveevaluationandclassificationofendoscopicfindingsforureteralcalculi AT ryosukeando prospectiveevaluationandclassificationofendoscopicfindingsforureteralcalculi AT atsushiokada prospectiveevaluationandclassificationofendoscopicfindingsforureteralcalculi AT hiroyasumiura prospectiveevaluationandclassificationofendoscopicfindingsforureteralcalculi AT tadashimatsuda prospectiveevaluationandclassificationofendoscopicfindingsforureteralcalculi AT takahiroyasui prospectiveevaluationandclassificationofendoscopicfindingsforureteralcalculi
_version_	1718384072510668800

Prospective evaluation and classification of endoscopic findings for ureteral calculi

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