Work

Construction of a Risk Prediction Model for Ureteral Stricture after Ureteroscopic Holmium Laser Lithotripsy

Year: 2024

Type: article

Abstract: Objective To analyze the influencing factors of ureteral stenosis after ureteroscopic holmium laser lithotripsy. Methods The clinical data of 427 patients treated with ureteroscopic holmium laser lithotripsy were selected, and the patients were divided into two groups according to whether the patients had ureteral stenosis after operation. Univariate and multivariate Logistic regression were used to analyze the independent risk factors for postoperative ureteral stenosis, and R software and regression coefficients were used to construct a predictive model. Results After a one-year follow-up of 427 patients, 28 patients (6.56%) developed ureteral stenosis; univariate analysis showed that the occurrence of ureteral stenosis after subureteral holmium laser lithotripsy was related to stone diameter, stone incarceration,degree of hydronephrosis, holmium laser injury of mucosa, and operation time (P<0.05); further Logistic regression analysis showed that long stone diameter, stone incarceration, and moderate to severe hydronephrosis were independent risk factors for ureteral stricture after ureteroscopic holmium laser lithotripsy (P<0.05); the H-L deviation degree and the area under the ROC curve were used to test, and the results showed that the model had high accuracy and discrimination. Conclusion Stone diameter, stone incarceration, and degree of hydronephrosis were independent risk factors that affect the occurrence of ureteral stricture after ureteroscopic holmium laser lithotripsy. The nomogram model established by this result has high accuracy and discrimination. It can effectively identify high-risk groups to prevent ureteral stenosis in time and minimize the risk of ureteral stenosis after surgery.

Source: Journal of Endourology

DOI: 10.1089/end.2023.0638