Predictive Value Of Ureteral Wall Thickness On The Success Rate Of Retrograde Ureteral Stent Placement In Patients With Obstructive Ureteral Calculi

Objective:To investigate the predictive value of ureteral wall thickness on the success rate of retrograde ureteral stent placement in patients with obstructive ureteral calculi.Methods:The clinical data of patients undergoing retrograde ureteral stent(RUS)due to obstructive ureteral calculi in our hospital from February 2017 to December 2021 were collected and retrospectively studied.Including gender,age,body mass index(BMI),degree of hydronephrosis,stone side,stone location,stone CT value,ureteral wall thickness(UWT)at the site of stone obstruction,maximum transverse diameter of stone,maximum long diameter of stone,5mm ureteral diameter above the stone and other related clinical indicators.To analyze the correlation between various clinical indicators and the successful passage of retrograde ureteral stent through the site of calculus obstruction.Univariate analysis of the collected clinical parameters usingχ~2 test or t test.Binary logistic regression analysis was performed on the predictors of P<0.05 to determine the independent predictors of successful passage of the ureteral stent through the site of stone obstruction in RUS.The best predictor of successful passage of a retrograde ureteral stent through the site of stone obstruction was determined by drawing ROC curve analysis.Results:A total of 125 patients with obstructive ureteral calculi were included in this study,including 82 patients with successful retrograde ureteral stent placement,and 43 patients who underwent percutaneous nephrostomy because the ureteral stent could not pass through the stone obstruction.Univariate analysis showed that the degree of hydronephrosis,the maximum long diameter of the stone,the maximum transverse diameter of the stone,the diameter of the 5mm ureter above the stone,and the thickness of the ureteral wall were related to the successful placement of the ureteral stent.The results of binary logistic regression analysis showed that the maximum long diameter of the stone(P=0.039),the maximum transverse diameter of the stone(P=0.029)and UWT(P<0.001)were independent predictors of the successful passage of the retrograde ureteral stent through the obstructive site of the stone.The ROC curve showed that the area under the curve of UWT value at the stone obstruction was the largest(AUC=0.791,P<0.001),which was the best predictor.Conclusion:This study shows that the thickness of the ureteral wall at the site of stone obstruction has a high predictive value for the successful passage of the retrograde ureteral stent through the site of stone obstruction,and provides important guidance for the selection of preoperative surgical plans...