Skip to main content
SpringerLink
Log in

Ureteral stone volume and female gender predicts perioperative complications after complete ipsilateral upper urinary tract stone removal using flexible ureterorenoscopy

  • Urology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Purpose

To identify the risk factors for perioperative complications to prevent perioperative complications after complete ipsilateral upper urinary stone removal using flexible ureterorenoscopy.

Materials and methods

We retrospectively examined 111 patients who underwent flexible ureterorenoscopy for ipsilateral renal stones with a diameter ≥ 5 mm at the same time as ureterorenoscopy for ureteric stones. The flexible ureterorenoscopy procedures were performed following the fragmentation technique. Patients who experienced (complication group) and did not experience (non-complication group) perioperative complications were compared. The complication group included 33 patients with Clavien–Dindo classification scores of I, II, III, or IV and/or those with a body temperature of > 37.5 ℃ during hospitalization.

Results

The overall stone volume, stone-free rate and procedure duration were 1.71 mL, 96.4% and 77 min, respectively. The rate of perioperative complications was 29.7% (grade 1, 2 and 3 was 23.4%, 5.4% and 0.9%, respectively). Severe complications (Clavien–Dindo grade 4) were not observed. Multivariable analysis revealed that ureteral stone volume and female patients were independent predictors of perioperative complications after flexible ureterorenoscopy (p = 0.015 and 0.017, respectively).

Conclusions

This study showed that ureteral stone volume and female gender have the possibility to increase perioperative complications. These preliminary data help to select for patients who are at low risk of complications. Therefore, in these selected patients, complete ipsilateral upper urinary tract stone removal using flexible ureterorenoscopy may reduce the recurrence of urolithiasis without increasing perioperative complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

No additional data are available.

Abbreviations

fURS:

Flexible ureterorenoscopy

MET:

Medical expulsive therapy

NCCT:

Non-contrast computed tomography

PCNL:

Percutaneous nephrolithotomy

PS:

Performance status

SFR:

Stone-free rate

SWL:

Shock wave lithotripsy

URS:

Ureterorenoscopy

References

  1. Breda A, Ogunyemi O, Leppert JT et al (2009) Flexible ureteroscopy and laser lithotripsy for multiple unilateral intrarenal stones. Eur Urol 55:1190

    Article  PubMed  Google Scholar 

  2. El-Nahas AR, Ibrahim HM, Youssef RF et al (2012) Flexible ureterorenoscopy versus extracorporeal shock wave lithotripsy for treatment of lower pole stones of 10–20 mm. BJU Int 110:898

    Article  PubMed  Google Scholar 

  3. Cohen J, Cohen S, Grasso M (2013) Ureteropyeloscopic treatment of large, complex intrarenal and proximal ureteral calculi. BJU Int 111:E127

    Article  PubMed  Google Scholar 

  4. Breda A, Ogunyemi O, Leppert JT et al (2008) Flexible ureteroscopy and laser lithotripsy for single intrarenal stones 2 cm or greater-is this the new frontier? J Urol 179:981

    Article  PubMed  Google Scholar 

  5. Pearle MS, Lingeman JE, Leveillee R et al (2008) Prospective randomized trial comparing shock wave lithotripsy and ureteroscopy for lower pole caliceal calculi 1 cm or less. J Urol 179:2005

    Article  Google Scholar 

  6. Komeya M, Usui K, Asai T et al (2018) Outcome of flexible ureteroscopy for renal stone with overnight ureteral catheterization: a propensity score-matching analysis. World J Urol 36:1871

    Article  PubMed  Google Scholar 

  7. Komeya M, Odaka H, Asano J et al (2019) Development and internal validation of a nomogram to predict perioperative complications after flexible ureteroscopy for renal stones in overnight ureteral catheterization cases. World J Urol 38:2307

    Article  PubMed  Google Scholar 

  8. Komeya M, Odaka H, Watanabe T et al (2020) Gap between UAS and ureteroscope predicts renal stone-free rate after flexible ureteroscopy with the fragmentation technique. World J Urol. https://doi.org/10.1007/s00345-020-03459-7

    Article  PubMed  Google Scholar 

  9. Raheem OA, Khandwala YS, Sur RL et al (2017) Burden of urolithiasis: trends in prevalence, treatments, and costs. Eur Urol Focus 3:18

    Article  PubMed  Google Scholar 

  10. Giusti G, Proietti S, Villa L et al (2016) Current standard technique for modern flexible ureteroscopy: tips and tricks. Eur Urol 70:188

    Article  PubMed  Google Scholar 

  11. Scotland KB, Rudnick B, Healy KA et al (2018) Retrograde ureteroscopic management of large renal calculi: a single institutional experience and concise literature review. J Endourol 32:603

    Article  PubMed  Google Scholar 

  12. Geraghty RM, Rai BP, Jones P et al (2017) Bilateral simultaneous ureteroscopic (BS-URS) approach in the management of bilateral urolithiasis is a safe and effective strategy in the contemporary era—evidence from a systematic review. Curr Urol Rep 18:11

    Article  PubMed  PubMed Central  Google Scholar 

  13. Inci K, Sahin A, Islamoglu E et al (2007) Prospective long-term followup of patients with asymptomatic lower pole caliceal stones. J Urol 177:2189

    Article  PubMed  Google Scholar 

  14. Osman MM, Alfano Y, Kamp S et al (2005) 5-Year-follow-up of patients with clinically insignificant residual fragments after extracorporeal shockwave lithotripsy. Eur Urol 47:860

    Article  PubMed  Google Scholar 

  15. El-Nahas AR, El-Assmy AM, Madbouly K et al (2006) Predictors of clinical significance of residual fragments after extracorporeal shockwave lithotripsy for renal stones. J Endourol 20:870

    Article  PubMed  Google Scholar 

  16. Buchholz NP, Meier-Padel S, Rutishauser G (1997) Minor residual fragments after extracorporeal shockwave lithotripsy: spontaneous clearance or risk factor for recurrent stone formation? J Endourol 11:227

    Article  CAS  PubMed  Google Scholar 

  17. Ito H, Kawahara T, Terao H et al (2012) The most reliable preoperative assessment of renal stone burden as a predictor of stone-free status after flexible ureteroscopy with holmium laser lithotripsy: a single-center experience. Urology 80:524

    Article  PubMed  Google Scholar 

  18. Rubenstein RA, Zhao LC, Loeb S et al (2007) Presenting improves ureteroscopic stone-free rates. J Endourol 21:1277

    Article  PubMed  Google Scholar 

  19. Shields JM, Bird VG, Graves R et al (2009) Impact of preoperative ureteral stenting on outcome of ureteroscopic treatment for urinary lithiasis. J Urol 182:2768

    Article  PubMed  Google Scholar 

  20. Ahn ST, Kim JH, Park JY et al (2012) Acute postoperative pain after ureteroscopic removal of stone: incidence and risk factors. Korean J Urol 53:34

    Article  PubMed  PubMed Central  Google Scholar 

  21. Darrad MP, Yallappa S, Metcalfe J et al (2018) The natural history of asymptomatic calyceal stones. BJU Int 122:263

    Article  PubMed  Google Scholar 

  22. Geavlete P, Georgescu D, Niţǎ G et al (2006) Complications of 2735 retrograde semirigid ureteroscopy procedures: a single-center experience. J Endourol 20:179

    Article  PubMed  Google Scholar 

  23. Perez Castro E, Osther PJS, Jinga V et al (2014) Differences in ureteroscopic stone treatment and outcomes for distal, mid-, proximal, or multiple ureteral locations: the clinical research office of the endourological society ureteroscopy global study. Eur Urol 66:102

    Article  PubMed  Google Scholar 

  24. Chew BH, Brotherhood HL, Sur RL et al (2016) Natural history, complications and re-intervention rates of asymptomatic residual stone fragments after ureteroscopy: a report from the EDGE Research Consortium. J Urol 195:982

    Article  PubMed  Google Scholar 

Download references

Funding

This study was funded by a Grant-in-Aid for Scientific Research (C) 19K09718 (to M.J. and K.M.).

Author information

Authors and Affiliations

  1. Department of Urology, Ohguchi East General Hospital, 2-19-1 Irie, Kanagawa-Ku, Yokohama, Kanagawa, 221-0014, Japan

    Takahiko Watanabe, Mitsuru Komeya, Hisakazu Odaka, Hirokazu Kiuchi & Junichi Matsuzaki

  2. Department of Urology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan

    Mitsuru Komeya & Kazuhide Makiyama

  3. Department of Biostatistics, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan

    Yusuke Saigusa

Authors
  1. Takahiko Watanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mitsuru Komeya
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hisakazu Odaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hirokazu Kiuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yusuke Saigusa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kazuhide Makiyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Junichi Matsuzaki
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

TW: data collection and manuscript writing. MK: project development, data collection, and manuscript writing. KO: data collection. HK: data collection. YS: data analysis. KM: project development. JM: project development.

Corresponding author

Correspondence to Mitsuru Komeya.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

This study was approved by the institutional ethics committee of Ohguchi East General Hospital.

Research involving human participants and/or animals

This study was approved by the Institutional Ethics Committee of Ohguchi East General Hospital.

Informed consent

Informed consent was obtained from all participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Watanabe, T., Komeya, M., Odaka, H. et al. Ureteral stone volume and female gender predicts perioperative complications after complete ipsilateral upper urinary tract stone removal using flexible ureterorenoscopy. Int Urol Nephrol 56, 1611–1616 (2024). https://doi.org/10.1007/s11255-023-03899-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-023-03899-1

Keywords

Search

Navigation