1540 PREDICTORS FOR NOT FINDING A STONE DURING URETEROSCOPY AFTER EMERGENCY DRAINAGE OF THE UPPER TRACT BY DOUBLE J URETERAL STENT

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You have accessJournal of UrologyStone Disease: SWL, Ureteroscopy or Percutaneous Stone Removal (I)1 Apr 20131540 PREDICTORS FOR NOT FINDING A STONE DURING URETEROSCOPY AFTER EMERGENCY DRAINAGE OF THE UPPER TRACT BY DOUBLE J URETERAL STENT Shmuel Roizman, Ilia Beberashvili, Yaniv Shilo, Yoram Siegel, Erez Lung, Kobi Stav, Amnon Zisman, Arie Lindner, and Dan Leibovici Shmuel RoizmanShmuel Roizman rishon lezion, Israel More articles by this author , Ilia BeberashviliIlia Beberashvili rishon lezion, Israel More articles by this author , Yaniv ShiloYaniv Shilo rishon lezion, Israel More articles by this author , Yoram SiegelYoram Siegel rishon lezion, Israel More articles by this author , Erez LungErez Lung rishon lezion, Israel More articles by this author , Kobi StavKobi Stav rishon lezion, Israel More articles by this author , Amnon ZismanAmnon Zisman rishon lezion, Israel More articles by this author , Arie LindnerArie Lindner rishon lezion, Israel More articles by this author , and Dan LeiboviciDan Leibovici rishon lezion, Israel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.3030AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Patients who undergo emergency drainage for an obstructed upper urinary tract by stones often undergo subsequent uerteroscopy as a definitive procedure. However, in some, the obstructing stone will not be found at ureteroscopy. Our purpose was to identify predictors of not finding ureteral stones in patients who had undergone previous drainage by stents. METHODS 102 consecutive patients in whom a double J stent was inserted underwent subsequent ureteroscopy. Demographical, clinical, laboratory and imaging data were collected retrospectively. Stone presence was determined by endoscopy and retrograde fluoroscopy during ureteroscopy. Univariate and multivariate logistic regression analysis were performed to identify predictors for the presence of stone in the urinary tract. Receiver operator curve was used to identify the stone diameter cutoff that best predicts stone presence. RESULTS in 35 patients (34.3%) the stone was not found in the urinary tract during ureteroscopy. Univariate analysis showed that male gender and stone diameter were related to finding the stone in the urinary tract. Multivariate analysis found that stone diameter was the only predictor for stone presence in the urinary tract with a cutoff of 5.5 mm. Smaller stones had a higher probability not to be found in ureteroscopy (p= 0.033). Of all the ureteroscopies with stones smaller than 5.5 mm (43) there were 22 in which no stone was found (51.2%). For stones larger then 5.5 mm the proportion was 13 out of 59 (22%). thus the likelihood of not finding the stone is twice higher for smaller versus larger stones. CONCLUSIONS in 34% of the patients who underwent ureteroscopy after previous ureteral stent insertion the stone was not found. Stone diameter is an independent predictor of stone presence. Stones smaller than 5.5mm are less likely to be found at ureteroscopy, The probability to find a stone larger then 5.5 mm is twice as higher. Table 1. Stone finding probability: (OR=odds ratio; CI=confidence interval) univariate multivariate variable OR(95%-CI) P OR(95%-CI) P Age (↑ 1y) 1.014 (0.985-1043) 0.350 1.026 (0.992-1.061) 0.134 Gender (m) 5.000 (1.074-23.274) 0.040 4.657 (0.883-24.556) 0.070 Previous ureteroscopy 0.241 (0.028-2.040) 0.192 0.238 (0.025-2.230) 0.209 Stone size(↑ 1mm') 0.682 (0.552-0.843) 0.0001 0.750 (0.599-0.940) 0.012 Side (right) 0.554 (0.244-1.258) 0.158 1.823 (0.721-4.610) 0.204 Stone location (distal ureter) 1.458 (0.643-3.306) 0.732 0.553 (0.189-1.620) 0.280 © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e631-e632 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shmuel Roizman rishon lezion, Israel More articles by this author Ilia Beberashvili rishon lezion, Israel More articles by this author Yaniv Shilo rishon lezion, Israel More articles by this author Yoram Siegel rishon lezion, Israel More articles by this author Erez Lung rishon lezion, Israel More articles by this author Kobi Stav rishon lezion, Israel More articles by this author Amnon Zisman rishon lezion, Israel More articles by this author Arie Lindner rishon lezion, Israel More articles by this author Dan Leibovici rishon lezion, Israel More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...