Predictive factors for intraoperative complications in semirigid ureteroscopy: analysis of 1235 ballistic ureterolithotripsies

Abstract

Objectives: To evaluate potential preoperative predictive factors for complications in ureteroscopic treatment of ureteral stones.

Methods: One thousand two hundred thirty-five semirigid ureteroscopies for ureteral stones were prospectively inserted in our database and analyzed for complications. Preoperative variables evaluated were as follows: age, gender, length of symptoms, previous extracorporeal shock wave lithotripsy (ESWL), associated urinary tract infection (UTI), stone location, and degree of hydronephrosis. Univariate analysis and multivariate logistic regression were conducted.

Results: Fifty-five (4.4%) procedures had complications. There were 8 ureteral perforations, 5 paraureteral stones, 2 ureteral avulsions, 5 mucosal eversions, 1 urethral injury, and 34 mucosal tears. In univariate analysis, age (P = .000), gender (P = .002), previous ESWL (P = .047), stone size (P = .001), and location (P = .001) were predictors of complications. Gender (P = .012), previous in situ ESWL (P = .037), stone size (P = .025), and location (P = .019) remained predictors in multivariate logistic regression.

Conclusions: Semirigid ureteroscopy is a safe procedure with few complications. Larger stones, proximally located (iliac vessels or above) with previous in situ ESWL in men are preoperative predictors for intraoperative complications.