Iatrogenic ureteral strictures (US) after endoscopic treatment for urolithiasis represent a significant healthcare concern. However, high-quality evidence on the risk factors associated with US is currently lacking. We aimed to develop a consensus statement addressing the definition, risk factors, and follow-up management of iatrogenic US after endoscopic treatment for urolithiasis.
Utilizing a modified Delphi method, a steering committee developed survey statements based on a systematic literature review. Then, a two-round online survey was submitted to 25 experts, offering voting options to assess agreement levels. A consensus panel meeting was held for unresolved statements. The predetermined consensus threshold was set at 70%.
The steering committee formulated 73 statements. In the initial survey, consensus was reached on 56 (77%) statements. Following in-depth discussions and refinement of 17 (23%) statements in a consensus meeting, the second survey achieved consensus on 63 (86%) statements. This process underscored agreement on pivotal factors influencing US in endoscopic urolithiasis treatments.
This study provides a comprehensive list of categorized risk factors for US following endoscopic urolithiasis treatments. The objectives include enhancing uniformity in research, minimizing redundancy in outcome assessments, and effectively addressing risk factors associated with US. These findings are crucial for designing future clinical trials and guiding endoscopic surgeons in mitigating the risk of US.
World journal of urology. 2024 Jul 13*** epublish ***
Stefano Moretto, A Saita, C M Scoffone, M Talso, B K Somani, O Traxer, O Angerri, E Liatsikos, Y Ulvik, C M Cracco, E X Keller, A Pietropaolo, T Tailly, M Corrales, V De Coninck, U Nagele, S Ferretti, P Kronenberg, L Carmignani, P J Osther, I K Goumas, L Ajayi, P Acquati, D Perez-Fentes, T R W Herrmann, N M Buffi
Department of Biomedical Sciences, Humanitas University, Milan, Italy. ., Department of Urology, Humanitas Clinical and Research Institute IRCCS, Rozzano, Italy., Department of Urology, Cottolengo Hospital, Turin, Italy., Department of Urology, Luigi Sacco University Hospital, Milan, Italy., Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK., Department of Urology, Sorbonne Université, Paris, France., Department of Urology, Fundació Puigvert University Autonoma de Barcelona, Barcelona, Spain., Department of Urology, University Hospital of Patras, Patras, Greece., Department of Urology, Haukeland University Hospital, Bergen, Norway., Department of Urology, University Hospital Zurich, Zurich, Switzerland., Department of Urology, University Hospital Ghent, Ghent, Belgium., Department of Urology, AZ Klina, Brasschaat, Belgium., Department of Urology, General Hospital Hall in Tirol, Hall in Tirol, Austria., Department of Urology, Azienda Ospedaliero-Universitaria di Modena, Baggiovara, Italy., Department of Urology, Hospital CUF Descobertas, Lisbon, Portugal., Department of Urology, University of Milan, Milan, Italy., Department of Urology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark., Department of Urology, Istituto Clinico Beato Matteo, Vigevano, Italy., Department of Urology, Royal Free London NHS Foundation Trust, London, UK., Department of Urology, IRCCS Policlinico San Donato, Milan, Italy., Department of Urology, University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain., Department of Urology, Spital Thurgau AG, Frauenfeld, Switzerland., Department of Biomedical Sciences, Humanitas University, Milan, Italy.