Clinical factors associated with postoperative hydronephrosis after ureteroscopic lithotripsy.
This study aimed to determine the predictors of ipsilateral hydronephrosis after ureteroscopic lithotripsy for ureteral calculi.



From January 2010 to December 2014, a total of 204 patients with ureteral calculi who underwent ureteroscopic lithotripsy were reviewed. Patients with lack of clinical data, presence of ureteral rupture, and who underwent simultaneous percutaneous nephrolithotomy (PNL) were excluded. Postoperative hydronephrosis was determined via computed tomographic scan or renal ultrasonography, at 6 months after ureteroscopic lithotripsy. Multivariable analysis was performed to determine clinical factors associated with ipsilateral hydronephrosis.



A total of 137 patients were enrolled in this study. The mean age of the patients was 58.8±14.2 years and the mean stone size was 10.0±4.6 mm. The stone-free rate was 85.4%. Overall, 44 of the 137 patients (32.1%) had postoperative hydronephrosis. Significant differences between the hydronephrosis and nonhydronephrosis groups were noted in terms of stone location, preoperative hydronephrosis, impacted stone, operation time, and ureteral stent duration (all, p<0.05). On multivariable analysis, increasing preoperative diameter of the hydronephrotic kidney (adjusted odds ratio [OR], 1.21; 95% confidence interval [CI], 1.12-1.31; p=0.001) and impacted stone (adjusted OR, 3.01; 95% CI, 1.15-7.61; p=0.031) independently predicted the occurrence of postoperative hydronpehrosis.



Large preoperative diameter of the hydronephrotic kidney and presence of impacted stones were associated with hydronephrosis after ureteroscopic stone removal. Therefore, patients with these predictive factors undergo more intensive imaging follow-up in order to prevent renal deterioration due to postoperative hydronephrosis.
Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
Sun Woo
SW
Kim
Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
Ji Hoon
JH
Ahn
Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
Sang Un
SU
Yim
Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
Yang Hyun
YH
Cho
Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
Bo Sung
BS
Shin
Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
Ho Seok
HS
Chung
Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
Eu Chang
EC
Hwang
Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
Ho Song
HS
Yu
Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
Kyung Jin
KJ
Oh
Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
Sun-Ouck
SO
Kim
Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
Seung Il
SI
Jung
Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
Taek Won
TW
Kang
Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
Dong Deuk
DD
Kwon
Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
Kwangsung
K
Park
D000328:Adult; D000368:Aged; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000209:etiology*; D008096:Lithotripsy / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014514:Ureteral Calculi / Q000473:pathology / Q000601:surgery*; D018666:Ureteroscopy / Q000009:adverse effects*
Hydronephrosis; Ureteral calculi; Ureteroscopy