Scholarlink

Objectives <p>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&#xa0;years postoperatively, thereby facilitating individualized follow-up.</p> Methods <p>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 (<i>n</i> = 70) were patients diagnosed with postoperative ureteral stricture; controls (<i>n</i> = 70) were selected using propensity score matching (age, sex, stone laterality, surgery date) from patients without stricture. <i>T</i>-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.</p> Results <p>Hypertension incidence (<i>P</i> = 0.038), ureteral stent placement time (<i>P</i> = 0.002), stone location (<i>P</i> = 0.04), and hydronephrosis grade (<i>P</i> &lt; 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.</p> Conclusion <p>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.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Ureteral stricture prediction of occurrence after ureteroscopic lithotripsy

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月25日

查看全文
  • Yuchen Gao,
  • Shuai Liu,
  • Jun Luo,
  • Nueraihemaiti Yimingniyizi,
  • Xiao Xu,
  • Hongmin Zhou,
  • Yunze Dong,
  • Bowen Chen,
  • Hao Chen,
  • Yanhua Chen,
  • Xiangcheng Zhan,
  • Ding Liu,
  • Xudong Yao,
  • Tiancheng Xie,
  • Yunfei Xu

摘要

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.