Influences Of Ureteral Polyps On Endoscopic Treatment Of Upper Urinary Calculi

Objective:The relationship between ureteral polyps and ureteral lumen was assessed endoscopically,a grading method for the severity of ureteral polyps was developed,and the impact of different grades of ureteral polyps on the efficacy of endoscopic surgery for the endoluminal treatment of ureteral calculi was analysed to further assess the clinical application value of ureteral polyp grading.Subjects and Methods:The relationship between ureteral polyps and ureteral lumen was assessed endoscopically,a grading method for the severity of ureteral polyps was developed,and the impact of different grades of ureteral polyps on the efficacy of endoscopic surgery for the endoluminal treatment of ureteral calculi was analysed to further assess the clinical application value of ureteral polyp grading.Result:A total of 185 patients met the standards and included in this study.The retrograde intrarenal surgery(RIRS)group(104 cases)included 33 cases of Level 0,38 cases of Level 1,19 casesof Level 2 and 14 cases of Level 3.And the transurethhral ureteroscopic lithotripsy(URL)group(81 cases)comprised 24 cases of Level 0,21 cases of Level 1,17 cases of Level 2 and 19 cases of Level 3.There are statistical differences between ureteral polyp grading and age,surgical time,crossed-cavity time,bleeding,and postoperative ureteral stricture(P <0.05).Urinary polyp grading and gender,BMI value,basic disease,category of ureteroscope,calculi size,calculi position,residual calculi,hydronephrosisimprovement,postoperative hospitalization time,total hospital stay time,inflammation,postoperative fever do not have statistical differences(P >0.05).Multivariate linear regression analyzes resules are as follows.Ureteral polyps,calculi size and hospitalization time stay significantly correlation.Ureteral polyps,gender,calculi size and crossed-cavity time stay significantly differences.Calculi size,hydronephrosis grade and bleeding(hemoglobin)differences significant correlation.calculi size and postoperative hospitalization time were significantly related.Age,calculi and total hospital stay time were statistically significant.(P<0.05).Binary logistic regression further analysis of ureteral polyp grading(OR=2.853,P<0.05),BMI(OR=1.425,P<0.05),calculi location(OR=2.616,P<0.05)are important factors affecting ureteral stricture.Calculi location(P<0.05,OR=0.001)and BMI(OR=1.344,P<0.05)are important factors affecting residual calculi.Ureteral polyp classification(OR=0.187,P<0.05),calculi location(OR=2.506,P<0.05)and water accumulation Level(OR=292.022,P<0.05)are important factors affecting the improvement of hydronephrosis.Category of ureteroscope(OR=0.207,P<0.05),calculi size(OR=1.333,P<0.05),calculi(OR=2.357,P<0.05),calculi location(OR=0.088,P<0.05)are important factors affecting the aggravation of inflammation.Conclusions:Ureteral polyp grading can be applied to endoscopically manage patients with upper urinary calculi and has some clinical application,mainly in the assessment of operative time,crossed-cavity time,hydronephrosis and postoperative ureteral stricture rate.