BMC urology · 2026
Ureteral stricture prediction of occurrence after ureteroscopic lithotripsy.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Gao Yuchen, Liu Shuai, Luo Jun, Yimingniyizi Nueraihemaiti, Xu Xiao, Zhou Hongmin, Dong Yunze, Chen Bowen, Chen Hao, Chen Yanhua, Zhan Xiangcheng, Liu Ding, Yao Xudong, Xie Tiancheng, Xu Yunfei
Аннотация
OBJECTIVES: Ureteral stricture is a significant complication after ureteroscopic lithotripsy (URSL). This study aimed to identify risk factors for post-URSL ureteral stricture and develop a nomogram to predict the timing and probability of stricture occurrence within 1-3 years postoperatively, thereby facilitating individualized follow-up.
METHODS: We enrolled patients who underwent holmium laser ureteroscopic lithotripsy (URSL) at a single institution between January 1, 2014, and December 31, 2021, and were diagnosed with postoperative ureteral stricture. Baseline characteristics, in-hospital data, surgical indicators, computed tomography data, and laboratory test results of patients with and without stenosis were compared. Cases (n = 70) were patients diagnosed with postoperative ureteral stricture; controls (n = 70) were selected using propensity score matching (age, sex, stone laterality, surgery date) from patients without stricture. T-tests, Pearson's chi-squared, or Fisher's exact tests, LASSO and Cox regression analyses, receiver operating characteristic and Kaplan-Meier curve analyses, and nomogram analysis were used to predict post-URSL ureteral stricture risk factors and timing.
RESULTS: Hypertension incidence (P = 0.038), ureteral stent placement time (P = 0.002), stone location (P = 0.04), and hydronephrosis grade (P < 0.001) differed significantly between the groups, and stone impaction were independent risk factors for ureteral stricture. The nomogram showed good discrimination (C-index 0.720) and calibration. Preoperative fever appeared as a protective factor but should be interpreted cautiously due to potential confounding.
CONCLUSION: The nomogram, which based on hydronephrosis grade, ureteral stone location, and incarcerated stones can predict post-URSL ureteral stricture risk and may guide personalized follow-up. External validation is needed before clinical application.
METHODS: We enrolled patients who underwent holmium laser ureteroscopic lithotripsy (URSL) at a single institution between January 1, 2014, and December 31, 2021, and were diagnosed with postoperative ureteral stricture. Baseline characteristics, in-hospital data, surgical indicators, computed tomography data, and laboratory test results of patients with and without stenosis were compared. Cases (n = 70) were patients diagnosed with postoperative ureteral stricture; controls (n = 70) were selected using propensity score matching (age, sex, stone laterality, surgery date) from patients without stricture. T-tests, Pearson's chi-squared, or Fisher's exact tests, LASSO and Cox regression analyses, receiver operating characteristic and Kaplan-Meier curve analyses, and nomogram analysis were used to predict post-URSL ureteral stricture risk factors and timing.
RESULTS: Hypertension incidence (P = 0.038), ureteral stent placement time (P = 0.002), stone location (P = 0.04), and hydronephrosis grade (P < 0.001) differed significantly between the groups, and stone impaction were independent risk factors for ureteral stricture. The nomogram showed good discrimination (C-index 0.720) and calibration. Preoperative fever appeared as a protective factor but should be interpreted cautiously due to potential confounding.
CONCLUSION: The nomogram, which based on hydronephrosis grade, ureteral stone location, and incarcerated stones can predict post-URSL ureteral stricture risk and may guide personalized follow-up. External validation is needed before clinical application.