Predictors for Retrograde Ureteral Stenting Failure as an Initial Drainage Method for Emergent Complicated Acute Calculus Obstructive Uropathy

ObjectiveTo define predictors for initial retrograde ureteral stenting (RUS) failure with the need for the percutaneous nephrostomy (PCN) insertion as a drainage method in patients with complicated acute calculus obstructive uropathy. MethodsWe undertook a retrospective evaluation of...

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Main Authors: M.A. Elbaset, Mohamed Edwan, Rasha T. Abouelkheir, Rawdy Ashour, Mohamed Ramez, Abdalla Abdelhamid, Yasser Osman
Format: Article
Language:English
Published: MDPI AG 2021-07-01
Series:Société Internationale d’Urologie Journal
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Online Access:https://siuj.org/index.php/siuj/article/view/129/49
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author M.A. Elbaset
Mohamed Edwan
Rasha T. Abouelkheir
Rawdy Ashour
Mohamed Ramez
Abdalla Abdelhamid
Yasser Osman
author_facet M.A. Elbaset
Mohamed Edwan
Rasha T. Abouelkheir
Rawdy Ashour
Mohamed Ramez
Abdalla Abdelhamid
Yasser Osman
author_sort M.A. Elbaset
collection DOAJ
description ObjectiveTo define predictors for initial retrograde ureteral stenting (RUS) failure with the need for the percutaneous nephrostomy (PCN) insertion as a drainage method in patients with complicated acute calculus obstructive uropathy. MethodsWe undertook a retrospective evaluation of patients who presented with complicated obstructive calculus uropathy (acute renal failure or obstructive pyelonephritis) between January 2016 and January 2020. Patients in whom there was failure to visualize ipsilateral ureteric orifice and those with extrinsic ureteral obstruction were excluded. Patient demographics and radiological data including stone site, hydronephrosis grade, maximum transverse stone diameter, periureteral density (PUD) and pericalcular ureteric thickness (P-CUT) at the maximum transverse stone diameter were assessed using non-contrast computed tomography at the time of admission. ResultsThe study included 256 patients who were managed initially by RUS trial. Of them, 48 (18.8 %) had RUS failure. The presence of acute pyelonephritis, increased maximum transverse stone diameter ≥ 9.5 mm, P-CUT ≥ 7.5 mm, and PUD at stone level ≥ 17.5 HU were risk factors associated with RUS failure (P = 0.007, 0.002, < 0.001, and < 0.001, respectively). ConclusionInitial radiological stone and ureteric characteristics, in addition to the clinical diagnosis of obstructive pyelonephritis, can be used to determine PCN insertion as the preferred option over RUS for urinary drainage.
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spelling doaj-art-e8918abe219548c881be5599336168c72025-08-20T02:54:40ZengMDPI AGSociété Internationale d’Urologie Journal2563-64992021-07-012422923810.48083/OZUL6913Predictors for Retrograde Ureteral Stenting Failure as an Initial Drainage Method for Emergent Complicated Acute Calculus Obstructive UropathyM.A. ElbasetMohamed Edwan Rasha T. Abouelkheir Rawdy Ashour Mohamed RamezAbdalla AbdelhamidYasser OsmanObjectiveTo define predictors for initial retrograde ureteral stenting (RUS) failure with the need for the percutaneous nephrostomy (PCN) insertion as a drainage method in patients with complicated acute calculus obstructive uropathy. MethodsWe undertook a retrospective evaluation of patients who presented with complicated obstructive calculus uropathy (acute renal failure or obstructive pyelonephritis) between January 2016 and January 2020. Patients in whom there was failure to visualize ipsilateral ureteric orifice and those with extrinsic ureteral obstruction were excluded. Patient demographics and radiological data including stone site, hydronephrosis grade, maximum transverse stone diameter, periureteral density (PUD) and pericalcular ureteric thickness (P-CUT) at the maximum transverse stone diameter were assessed using non-contrast computed tomography at the time of admission. ResultsThe study included 256 patients who were managed initially by RUS trial. Of them, 48 (18.8 %) had RUS failure. The presence of acute pyelonephritis, increased maximum transverse stone diameter ≥ 9.5 mm, P-CUT ≥ 7.5 mm, and PUD at stone level ≥ 17.5 HU were risk factors associated with RUS failure (P = 0.007, 0.002, < 0.001, and < 0.001, respectively). ConclusionInitial radiological stone and ureteric characteristics, in addition to the clinical diagnosis of obstructive pyelonephritis, can be used to determine PCN insertion as the preferred option over RUS for urinary drainage.https://siuj.org/index.php/siuj/article/view/129/49retrograde stentingureteral wall densitypercutaneous nephrostomypyelonephritisureteral wall thicknessobstructive uropathystonejj stent
spellingShingle M.A. Elbaset
Mohamed Edwan
Rasha T. Abouelkheir
Rawdy Ashour
Mohamed Ramez
Abdalla Abdelhamid
Yasser Osman
Predictors for Retrograde Ureteral Stenting Failure as an Initial Drainage Method for Emergent Complicated Acute Calculus Obstructive Uropathy
Société Internationale d’Urologie Journal
retrograde stenting
ureteral wall density
percutaneous nephrostomy
pyelonephritis
ureteral wall thickness
obstructive uropathy
stone
jj stent
title Predictors for Retrograde Ureteral Stenting Failure as an Initial Drainage Method for Emergent Complicated Acute Calculus Obstructive Uropathy
title_full Predictors for Retrograde Ureteral Stenting Failure as an Initial Drainage Method for Emergent Complicated Acute Calculus Obstructive Uropathy
title_fullStr Predictors for Retrograde Ureteral Stenting Failure as an Initial Drainage Method for Emergent Complicated Acute Calculus Obstructive Uropathy
title_full_unstemmed Predictors for Retrograde Ureteral Stenting Failure as an Initial Drainage Method for Emergent Complicated Acute Calculus Obstructive Uropathy
title_short Predictors for Retrograde Ureteral Stenting Failure as an Initial Drainage Method for Emergent Complicated Acute Calculus Obstructive Uropathy
title_sort predictors for retrograde ureteral stenting failure as an initial drainage method for emergent complicated acute calculus obstructive uropathy
topic retrograde stenting
ureteral wall density
percutaneous nephrostomy
pyelonephritis
ureteral wall thickness
obstructive uropathy
stone
jj stent
url https://siuj.org/index.php/siuj/article/view/129/49
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