Predictors of success and hospitalization in semi-rigid ureteroscopy for lithiasis as an outpatient procedure.
OBJECTIVE
To analyze the outcomes, predictors of success and predictors of need for hospital admission in our series of patients who underwent ureteroscopy (URS) as a major outpatient surgery (MOS) procedure.


METHODS
We carried out a retrospective analysis of 402 patients who had undergone semi-rigid URS for ureteral calculi as a MOS procedure in our center between 2004 and 2012. Patients with previous DJ catheter were excluded. We classified the calculi according to their location (lumbar, pelvic, iliac), size (< or> 1cm) and number (single or multiple). Follow-up was done by plain X-ray of the abdomen and ultrasound one month after surgery. The procedure was considered successful when patients were free from the treated calculi or had ureteral fragments < 3 mm one month after surgery. Univariate and multivariate analyses were carried out to identify the factors involved in success and hospitalization not being required.


RESULTS
A total of 269 patients were included. The majority of the stones were single (92.2%), <1 cm in size (76.6%), pelvic (62.1%), and left-sided (57.2%). 89.6% of the procedures were performed as MOS and 82.2% were considered to be successful. In the multivariate analysis, left-sided (p<0.001) and pelvic location of the calculi (p=0,01) were found to be independent predictors for the success of the procedure In terms of hospital admission, the only independent predictor was the presence of intraoperative complications ( p=0.006).


CONCLUSIONS
Left-sided and pelvic locations were the independent predictors for the success of the URS. A lack of intraoperative complications was the independent predictor for not requiring hospitalisation.
Servicio de Urologia. Hospital Universitario de Fuenlabrada.Madrid.Spain.
Roberto
R
Molina Escudero
N
N
Gonzalez Avila
M
M
Alvarez Ardura
M A
MA
Egui Rojo
E
E
Ripalda Ferretti
L
L
Crespo Martinez
David
D
Rendon Sanchez
Alvaro
A
Paez Borda
D000328:Adult; D000556:Ambulatory Surgical Procedures; D000768:Anesthesia, General; D005260:Female; D006760:Hospitalization; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011183:Postoperative Complications / Q000453:epidemiology / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000601:surgery*; D018666:Ureteroscopy / Q000379:methods*