Hospital Assunção, São Bernardo do Campo, São Paulo, Brazil.

To evaluate potential preoperative predictive factors for complications in ureteroscopic treatment of ureteral stones.

One thousand two hundred thirty-five semirigid ureteroscopies for ureteral stones were prospectively inserted in our database and analyzed for complications. Preoperative variables evaluated were as follows: age, gender, length of symptoms, previous extracorporeal shock wave lithotripsy (ESWL), associated urinary tract infection (UTI), stone location, and degree of hydronephrosis. Univariate analysis and multivariate logistic regression were conducted.

Fifty-five (4.4%) procedures had complications. There were 8 ureteral perforations, 5 paraureteral stones, 2 ureteral avulsions, 5 mucosal eversions, 1 urethral injury, and 34 mucosal tears. In univariate analysis, age (P = .000), gender (P = .002), previous ESWL (P = .047), stone size (P = .001), and location (P = .001) were predictors of complications. Gender (P = .012), previous in situ ESWL (P = .037), stone size (P = .025), and location (P = .019) remained predictors in multivariate logistic regression.

Semirigid ureteroscopy is a safe procedure with few complications. Larger stones, proximally located (iliac vessels or above) with previous in situ ESWL in men are preoperative predictors for intraoperative complications.

Written by
Fuganti PE, Pires S, Branco R, Porto J.

Reference
Urology. 2008 Jul 14. Epub ahead of print.
doi:10.1016/j.urology.2008.05.042

PubMed Abstract
PMID:18632141

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