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Ureteral stricture formation after endoscopic removal of obstructing stones: could it be predicted with well-assessed radiological parameters?

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Abstract

The possible role of well-assessed radiological parameters in the prediction of ureteral stricture formation in cases with impacted obstructive ureteral calculi has been evaluated. 46 adult patients with or without ureteral stricture formation after ureteroscopic stone management were included. In addition to stone size and some certain radiological parameters including ureteral wall thickness (UWT) of the involved ureter at the impacted stone site was also measured and noted on computed tomography (CT) images. Parameters were evaluated in two subgroups of cases, namely: Group 1: patients in whom a ureteral stricture formed after endoscopic stone removal and Group 2: patients normal ureteral anatomy without any stricture formation. The possible relationship between the UWT values and degree of hydronephrosis (HN) with subsequent stricture formation was comparatively evaluated. All of the stones were proximal ureteral calculi in both groups. Both the degree of HN and proximal ureteral diameter (PUD) parenchymal was higher in cases with stricture formation. In addition, mean parenchymal thickness was lower and mean values of UWT measurements at the stone site were 3.70 ± 0.97 mm and 2.17 ± 0.26 mm in Groups 1 and 2, respectively. A cutoff value 2.49 mm for UWT was found to be highly predictive for stricture formation. UWT value calculated at the obstructing stone site was found to be predictive enough for the likelihood of ureteral stricture formation with high sensitivity and specificity . This evaluation along with some other radiological parameters may enable the urologists to follow such cases on this aspect with necessary measures taken.

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Authors and Affiliations

  1. Department of Urology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Research and Training Hospital, Health Sciences University, Istanbul, Turkey

    Cahit Sahin, Yavuz Karaca, Emre Burak Sahinler & Kemal Sarica

  2. Department of Urology, Umraniye Research and Training Hospital, Health Sciences University, Istanbul, Turkey

    Resul Sobay

  3. Department of Urology, Medeniyet University Göztepe Süleyman Yalçın City Hospital, Istanbul, Turkey

    Ozgur Arikan & Kemal Sarica

  4. Department of Urology, Kafkas University Health Research and Application Center, Kars, Turkey

    Mehmet Uslu

  5. Department of Urology, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey

    Fatih Bicaklioglu

  6. Department of Urology, Biruni University, Faculty of Medicine, Istanbul, Turkey

    Kemal Sarica

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  1. Cahit Sahin
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  2. Yavuz Karaca
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  4. Ozgur Arikan
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  6. Fatih Bicaklioglu
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  7. Emre Burak Sahinler
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  8. Kemal Sarica
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Contributions

KS: project development and manuscript writing. CS: project development and manuscript YK: data collection. writing. RS: data collection and manuscript writing. OA: data collection. FB: data collection. MU: data collection. EBS: data collection.

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Correspondence to Cahit Sahin.

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This retrospective study was conducted after receiving approval from the institutional review board.

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Sahin, C., Karaca, Y., Sobay, R. et al. Ureteral stricture formation after endoscopic removal of obstructing stones: could it be predicted with well-assessed radiological parameters?. Urolithiasis 52, 34 (2024). https://doi.org/10.1007/s00240-024-01530-1

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