Ureteral wall thickness as a predictor for non-invasive treatment success for steinstrasse. Can we save time?

Autor: Elbaset MA; Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt. abdelbaset.m.i@gmail.com.; Urology Department, Horus University, New Damietta, Egypt. abdelbaset.m.i@gmail.com., Taha DE; Urology Department, KafrELshiekh University, KafrELshiekh, Egypt., Anas M; Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt., Elghareeb A; Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt., Abouelkheir RT; Radiology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt., Ashour R; Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt., Sheir KZ; Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt., Osman Y; Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Jazyk: angličtina
Zdroj: World journal of urology [World J Urol] 2024 Mar 13; Vol. 42 (1), pp. 151. Date of Electronic Publication: 2024 Mar 13.
DOI: 10.1007/s00345-024-04874-w
Abstrakt: Purpose: We aimed to define factors affecting the non-invasive overall treatment success (medical expulsive therapy (MET) ± shock wave lithotripsy (SWL)) for uncomplicated ureteral steinstrasse (SS) clearance.
Methods: We retrospectively evaluated consecutive patients who underwent SWL for renal stones between 2017 and 2021. Patients with uncomplicated SS were included. All patient's demographic and radiological data, e.g., age, gender, pre-SWL stenting, SS site, type, leading stone size in widest diameter (< 10 mm and ≥ 10 mm), ureteral wall thickness (UWT) in mm against the leading stone were collected. If SS was diagnosed, medical treatment was given for 4 weeks. In case of MET failure, either SWL for the leading stones + MET or direct URS was done. Non-invasive treatment success (SFR) was considered if complete clearance of SS occurred with no complications or the need for invasive intervention.
Results: A total of 145 patients were included with mean age of 45.9 ± 12.4 years. SFR in case of MET only occurred in 27.9%. Complications happened in 26 patients (17.9%). Non-invasive treatment SFR was achieved in 78 patients (53.8%) totally where SS type I, leading stone size ≤ 10 mm type and decreased UWT around the leading stone increased treatment success.
Conclusion: Ureteral wall thickness is an important factor predicting SS management success. Besides the decreased UWT, non-invasive management should be offered for type I SS with leading stone ≤ 10 mm.
(© 2024. The Author(s).)
Databáze: MEDLINE
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