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Original Research

Complications encountered during the ureteroscopy and predictive factors


1 İdil Devlet Hastanesi, Şırnak

2 Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, İstanbul


DOI :
New J Urol. 2015; 10 (3): 15-21

Abstract

Objective: We aimed to evaluate compli-cations that occurred during ureteroscopy and predictive factors.

Material and Method: Patients’ files were retrospectively analyzed, who underwent ure-teroscopy for ureteral stone between 2001-2014. Totally 1015 patients and 1214 renal units ure-teroscopy interventions were included in our study. Clavien- Dindo classification was used for evaluation of the complications. Patients’ demographics, stone localization, stone size, im-pacted or not, power supply used for lithotripsy, strategy for the stone breaking and complicati-ons that occurred peri-operatively were analy-zed. Patients with (Group-1)  and without (Gro-up-2) complications were compared.

Results: Patients’ mean age was 43± 17 (1-90) years, stone free rate was 89% at first ses-sion. Median follow time was 7 months (3-86) in all patients and 12 months (3-86) inpatients with  complications. Overall, 227 (22 %) had complications. Of the patients, 80 had grade 1 or 2 complications. Upper stone localization (p=0.041), stone size bigger than 10 mm (p=0.02) and impacted stones (p= 0.016) were predictive factors for development of complications. Less complication rate was detected in patients who underwent ureteroscopy with “smash and go” strategy (1.3% vs. 7.6 % p=0.001). Mean patient age, gender, side, experience of the urologist, application of balloon dilatation at beginning of intervention, power supply used for lithotripsy were not predictive factors for the development of complications.

Conclusions: Localization of the stone in the upper ureter and stone size larger than 10 mm were detected to increase complication rate whereas application of “smash and go” strategy decreased complication rate in ureteroscopy and stone lithotripsy.

Key Words: Ureteroscopy, complication, impacted stone


Abstract

Objective: We aimed to evaluate compli-cations that occurred during ureteroscopy and predictive factors.

Material and Method: Patients’ files were retrospectively analyzed, who underwent ure-teroscopy for ureteral stone between 2001-2014. Totally 1015 patients and 1214 renal units ure-teroscopy interventions were included in our study. Clavien- Dindo classification was used for evaluation of the complications. Patients’ demographics, stone localization, stone size, im-pacted or not, power supply used for lithotripsy, strategy for the stone breaking and complicati-ons that occurred peri-operatively were analy-zed. Patients with (Group-1)  and without (Gro-up-2) complications were compared.

Results: Patients’ mean age was 43± 17 (1-90) years, stone free rate was 89% at first ses-sion. Median follow time was 7 months (3-86) in all patients and 12 months (3-86) inpatients with  complications. Overall, 227 (22 %) had complications. Of the patients, 80 had grade 1 or 2 complications. Upper stone localization (p=0.041), stone size bigger than 10 mm (p=0.02) and impacted stones (p= 0.016) were predictive factors for development of complications. Less complication rate was detected in patients who underwent ureteroscopy with “smash and go” strategy (1.3% vs. 7.6 % p=0.001). Mean patient age, gender, side, experience of the urologist, application of balloon dilatation at beginning of intervention, power supply used for lithotripsy were not predictive factors for the development of complications.

Conclusions: Localization of the stone in the upper ureter and stone size larger than 10 mm were detected to increase complication rate whereas application of “smash and go” strategy decreased complication rate in ureteroscopy and stone lithotripsy.

Key Words: Ureteroscopy, complication, impacted stone