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Renal pelvisteki idrarın üreter taşının impaktasyonunu belirlemedeki rolü

Year 2021, Volume: 4 Issue: 2, 148 - 156, 31.08.2021

Abstract

Renal pelvisteki idrarın üreter taşının impaktasyonunu belirlemedeki rolü
Özet
Amaç: Üreter taşının olduğu taraftaki renal pelvisin Hounsfield Ünitesi değerinin taşın impaktasyonu hakkında fikir verip veremeyeceğini değerlendirmek.
Materyal ve method: Üreter taşı nedeniyle opere edilen hastaların, demografik verileri ile operasyon öncesi çekilen kontrastsız tomografi filmine göre hesaplanan, taşın transvers ve en uzun boyutu, üst üreterin çapı, üst üreterin alt üreter çapına oranı, taş dansitesi, renal pelvisin ön arka çapı ile renal pelvisteki idrarın ve mesanedeki idrarın HU değeri, taşın impakte olduğu ve olmadığı iki grup arasında karşılaştırıldı.
Bulgular: Hastaların ortanca yaşı 44 (37 - 53) yıl olup, %86.4’ü erkekti. Yaş, cinsiyet, komorbidite, taraf ve taş lokalizasyonu bakımından gruplar arasında fark yoktu (p=0.067, p=0.073, p=0.093, p=0.0141 ve p=0.074, sırasıyla). Renal pelvisteki idrarın HU değeri ile mesanedeki idrarın HU değeri gruplar arasında karşılaştırıldığında anlamlı farklılık görülmedi (p=0.511, p=0.376, sırasıyla). Mesanedeki idrar dansitesinin renal pelvis dansitesine oranına bakıldığında gruplar arasında anlamlı fark yoktu (p=0.461). Transvers taş uzunluğu, en uzun taş boyutu, üst üreter çapı ve üst üreter çapının alt üreter çapına oranı, taş dansitesi ve renal pelvis AP çapı, taş impaktasyonu olan grupta istatistiksel olarak anlamlı olacak şekilde daha büyüktü (p<0.001, p<0.001, p<0.001, p=0.025, p=0.016 ve p<0.001 sırasıyla)
Sonuç: Transvers taş uzunluğunun, taşın en uzun boyutunun, üst üreter çapının, üst üreter çapının alt üreter çapına oranının, renal pelvis ön arka çapının ve taşın HU ünitesindeki artışın impaktasyonla ilişkisi gösterilmiştir. Renal pelvisin idrar HU değerinin impaktasyonla ilişkisi bulunamamıştır.
Abstract
Purpose: To evaluate whether the Hounsfield Unit value of the renal pelvis on the side of the ureteral stone has any predictive value about the impaction of the stone.
Material and method: Demographic data of the patients who were operated for ureteral stones and preoperative radiological parameters such as the transverse and longest size of the stone, the diameter of the upper ureter, the ratio of the upper ureter to the lower ureter diameter, the stone density, the anterior-posterior diameter of the renal pelvis, HU values of urine in the renal pelvis and urine in the bladder based on noncontrast computerized tomography were compared between the two groups with and without impacted stone.
Results: The median age of the patients was 44 (37 - 53) years, and 86.4% of patients were male. There was no difference between the groups in terms of age, gender, comorbidity, side and stone localization (p=0.067, p=0.073, p=0.093, p=0.0141 and p=0.074, respectively). When the HU value of urine in the renal pelvis and the HU of urine in the bladder were compared between the groups, no significant difference was observed (p=0.511, p=0.376, respectively). When the ratio of urinary density in the bladder to the renal pelvis density was analyzed, there was no significant difference between the groups (p=0.461). Transverse stone length, longest stone size, upper ureter diameter, and the ratio of upper ureter diameter to lower ureter diameter, stone density, and renal pelvis AP diameter were statistically significantly greater in the stone impaction group (p<0.001, p<0.001, p<0.001, p=0.025, p=0.016, and p<0.001, respectively)
Conclusion: The significant relationship were found between the length of the transverse stone, the longest dimension of the stone, the diameter of the upper ureter, the ratio of the diameter of the upper ureter to the diameter of the lower ureter, the anterior-posterior diameter of the renal pelvis and the increase in the HU unit of the stone with impaction status. The urinary HU value of the renal pelvis was not found to be associated with impaction status.

References

  • Referanslar Referans 1. Sarica K, Eryildirim B, Akdere H, Camur E, Sabuncu K, Elibol O. Could ureteral wall thickness have an impact on the operative and post-operative parameters in ureteroscopic management of proximal ureteral stones? Actas Urol Esp (Engl Ed). 2019 Nov;43(9):474-479. English, Spanish. doi: 10.1016/j.acuro.2018.10.003. Epub 2019 May 31. PMID: 31155374.
  • Referans 2. Seitz C, Tanovic E, Kikic Z, Fajkovic H. Impact of stone size, location, composition, impaction, and hydronephrosis on the efficacy of holmium:YAG-laser ureterolithotripsy. Eur Urol. 2007 Dec;52(6):1751-7. doi: 10.1016/j.eururo.2007.04.029. Epub 2007 Apr 18. PMID: 17459573.
  • Referans3.El-Nahas AR, El-Tabey NA, Eraky I, Shoma AM, El-Hefnawy AS, El-Assmy AM, Soliman S, Youssef RF, El-Kenawy MR, Shokeir AA, El-Kappany HA. Semirigid ureteroscopy for ureteral stones: a multivariate analysis of unfavorable results. J Urol. 2009 Mar;181(3):1158-62. doi: 10.1016/j.juro.2008.10.167. Epub 2009 Jan 18. PMID: 19152940.
  • Referans4. Georgescu D, Mulţescu R, Geavlete B, Geavlete P. Intraoperative complications after 8150 semirigid ureteroscopies for ureteral lithiasis: risk analysis and management. Chirurgia (Bucur). 2014 May-Jun;109(3):369-74. PMID: 24956343.
  • Referans5. Sarica K, Eryildirim B, Sahin C, Sabuncu K, Cetinel C, Narter F. Impaction of ureteral stones into the ureteral wall: Is it possible to predict? Urolithiasis. 2016 Aug;44(4):371-6. doi: 10.1007/s00240-015-0850-9. Epub 2015 Dec 11. PMID: 26662172.
  • Referans6. Yoshida T, Inoue T, Omura N, Okada S, Hamamoto S, Kinoshita H, Matsuda T. Ureteral Wall Thickness as a Preoperative Indicator of Impacted Stones in Patients With Ureteral Stones Undergoing Ureteroscopic Lithotripsy. Urology. 2017 Aug;106:45-49. doi: 10.1016/j.urology.2017.04.047. Epub 2017 May 9. PMID: 28499762.
  • Referans7. Legemate JD, Wijnstok NJ, Matsuda T, Strijbos W, Erdogru T, Roth B, Kinoshita H, Palacios-Ramos J, Scarpa RM, de la Rosette JJ. Characteristics and outcomes of ureteroscopic treatment in 2650 patients with impacted ureteral stones. World J Urol. 2017 Oct;35(10):1497-1506. doi: 10.1007/s00345-017-2028-2. Epub 2017 Mar 20. PMID: 28321499; PMCID: PMC5613106.
  • Referans8. Elibol O, Safak KY, Buz A, Eryildirim B, Erdem K, Sarica K. Radiological noninvasive assessment of ureteral stone impaction into the ureteric wall: A critical evaluation with objective radiological parameters. Investig Clin Urol. 2017 Sep;58(5):339-345. doi: 10.4111/icu.2017.58.5.339. Epub 2017 Jul 31. PMID: 28868505; PMCID: PMC5577330.
  • Referans9. Alelign T, Petros B. Kidney Stone Disease: An Update on Current Concepts. Adv Urol. 2018 Feb 4;2018:3068365. doi: 10.1155/2018/3068365. PMID: 29515627; PMCID: PMC5817324.
  • Referans10. Mugiya S, Ito T, Maruyama S, Hadano S, Nagae H. Endoscopic features of impacted ureteral stones. J Urol. 2004;171:89–91
  • Referans11. Morgentaler A, Bridge SS, Dretler SP. Management of the impacted ureteral calculus. J Urol. 1990;143:263–6
  • Referans12.Deliveliotis C, Chrisofos M, Albanis S, Serafetinides E, Varkarakis J, Protogerou V. Management and follow-up of impacted ureteral stones. Urol Int. 2003;70(4):269-72. doi: 10.1159/000070133. PMID: 12740489.
  • Referans13.Abat D, Börekoglu A, Altunkol A, Köse IÇ, Boga MS. Is there any predictive value of the ratio of the upper to the lower diameter of the ureter for ureteral stone impaction?. Curr Urol. 2021;00:000–000. doi: 10.1097/CU9.0000000000000019
  • Referans14. Hwang E, Kim YH, Yuk SM, Sul CK, Lim JS. Factors that predict spontaneous passage of a small distal ureteral stone <5 mm. J Endourol. 2010 Oct;24(10):1681-5. doi: 10.1089/end.2010.0092. PMID: 20677988.
  • Referans15. Pan J, Xue W, Xia L, Zhong H, Zhu Y, Du Z, Chen Q, Huang Y. Ureteroscopic lithotripsy in Trendelenburg position for proximal ureteral calculi: a prospective, randomized, comparative study. Int Urol Nephrol. 2014 Oct;46(10):1895-901. doi: 10.1007/s11255-014-0732-z. Epub 2014 May 14. PMID: 24824146.
Year 2021, Volume: 4 Issue: 2, 148 - 156, 31.08.2021

Abstract

References

  • Referanslar Referans 1. Sarica K, Eryildirim B, Akdere H, Camur E, Sabuncu K, Elibol O. Could ureteral wall thickness have an impact on the operative and post-operative parameters in ureteroscopic management of proximal ureteral stones? Actas Urol Esp (Engl Ed). 2019 Nov;43(9):474-479. English, Spanish. doi: 10.1016/j.acuro.2018.10.003. Epub 2019 May 31. PMID: 31155374.
  • Referans 2. Seitz C, Tanovic E, Kikic Z, Fajkovic H. Impact of stone size, location, composition, impaction, and hydronephrosis on the efficacy of holmium:YAG-laser ureterolithotripsy. Eur Urol. 2007 Dec;52(6):1751-7. doi: 10.1016/j.eururo.2007.04.029. Epub 2007 Apr 18. PMID: 17459573.
  • Referans3.El-Nahas AR, El-Tabey NA, Eraky I, Shoma AM, El-Hefnawy AS, El-Assmy AM, Soliman S, Youssef RF, El-Kenawy MR, Shokeir AA, El-Kappany HA. Semirigid ureteroscopy for ureteral stones: a multivariate analysis of unfavorable results. J Urol. 2009 Mar;181(3):1158-62. doi: 10.1016/j.juro.2008.10.167. Epub 2009 Jan 18. PMID: 19152940.
  • Referans4. Georgescu D, Mulţescu R, Geavlete B, Geavlete P. Intraoperative complications after 8150 semirigid ureteroscopies for ureteral lithiasis: risk analysis and management. Chirurgia (Bucur). 2014 May-Jun;109(3):369-74. PMID: 24956343.
  • Referans5. Sarica K, Eryildirim B, Sahin C, Sabuncu K, Cetinel C, Narter F. Impaction of ureteral stones into the ureteral wall: Is it possible to predict? Urolithiasis. 2016 Aug;44(4):371-6. doi: 10.1007/s00240-015-0850-9. Epub 2015 Dec 11. PMID: 26662172.
  • Referans6. Yoshida T, Inoue T, Omura N, Okada S, Hamamoto S, Kinoshita H, Matsuda T. Ureteral Wall Thickness as a Preoperative Indicator of Impacted Stones in Patients With Ureteral Stones Undergoing Ureteroscopic Lithotripsy. Urology. 2017 Aug;106:45-49. doi: 10.1016/j.urology.2017.04.047. Epub 2017 May 9. PMID: 28499762.
  • Referans7. Legemate JD, Wijnstok NJ, Matsuda T, Strijbos W, Erdogru T, Roth B, Kinoshita H, Palacios-Ramos J, Scarpa RM, de la Rosette JJ. Characteristics and outcomes of ureteroscopic treatment in 2650 patients with impacted ureteral stones. World J Urol. 2017 Oct;35(10):1497-1506. doi: 10.1007/s00345-017-2028-2. Epub 2017 Mar 20. PMID: 28321499; PMCID: PMC5613106.
  • Referans8. Elibol O, Safak KY, Buz A, Eryildirim B, Erdem K, Sarica K. Radiological noninvasive assessment of ureteral stone impaction into the ureteric wall: A critical evaluation with objective radiological parameters. Investig Clin Urol. 2017 Sep;58(5):339-345. doi: 10.4111/icu.2017.58.5.339. Epub 2017 Jul 31. PMID: 28868505; PMCID: PMC5577330.
  • Referans9. Alelign T, Petros B. Kidney Stone Disease: An Update on Current Concepts. Adv Urol. 2018 Feb 4;2018:3068365. doi: 10.1155/2018/3068365. PMID: 29515627; PMCID: PMC5817324.
  • Referans10. Mugiya S, Ito T, Maruyama S, Hadano S, Nagae H. Endoscopic features of impacted ureteral stones. J Urol. 2004;171:89–91
  • Referans11. Morgentaler A, Bridge SS, Dretler SP. Management of the impacted ureteral calculus. J Urol. 1990;143:263–6
  • Referans12.Deliveliotis C, Chrisofos M, Albanis S, Serafetinides E, Varkarakis J, Protogerou V. Management and follow-up of impacted ureteral stones. Urol Int. 2003;70(4):269-72. doi: 10.1159/000070133. PMID: 12740489.
  • Referans13.Abat D, Börekoglu A, Altunkol A, Köse IÇ, Boga MS. Is there any predictive value of the ratio of the upper to the lower diameter of the ureter for ureteral stone impaction?. Curr Urol. 2021;00:000–000. doi: 10.1097/CU9.0000000000000019
  • Referans14. Hwang E, Kim YH, Yuk SM, Sul CK, Lim JS. Factors that predict spontaneous passage of a small distal ureteral stone <5 mm. J Endourol. 2010 Oct;24(10):1681-5. doi: 10.1089/end.2010.0092. PMID: 20677988.
  • Referans15. Pan J, Xue W, Xia L, Zhong H, Zhu Y, Du Z, Chen Q, Huang Y. Ureteroscopic lithotripsy in Trendelenburg position for proximal ureteral calculi: a prospective, randomized, comparative study. Int Urol Nephrol. 2014 Oct;46(10):1895-901. doi: 10.1007/s11255-014-0732-z. Epub 2014 May 14. PMID: 24824146.
There are 15 citations in total.

Details

Primary Language Turkish
Subjects Urology
Journal Section Articles
Authors

Deniz Abat 0000-0001-5801-2061

Fatih Gokalp 0000-0003-3099-3317

Ali Çam This is me

Onur Karslı 0000-0002-6451-9149

Publication Date August 31, 2021
Acceptance Date August 30, 2021
Published in Issue Year 2021 Volume: 4 Issue: 2

Cite

APA Abat, D., Gokalp, F., Çam, A., Karslı, O. (2021). Renal pelvisteki idrarın üreter taşının impaktasyonunu belirlemedeki rolü. Journal of Cukurova Anesthesia and Surgical Sciences, 4(2), 148-156.

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