RISK FACTORS PREDICTING FAILURE OF RETROGRADE URETERAL STENT INSERTION IN MANAGEMENT OF CALCULOUS URETERAL OBSTRUCTION. OUR TERTIARY INSTITUTE EXPERIENCE.

Abstract

Background: Calculus ureteric obstruction is known to cause signicant morbidity if not intervened early. DJ stenting is an established practise for relieving calculus ureteric obstruction. Objectives: Analysis of risk factors predicting failure of retrograde ureteric stenting in managing patients with calculous ureteric obstruction. Methods: This is retrospective study of cases between August 2014 and April 2015. Ninety eight patients of calculous ureteral obstruction including 16 bilateral cases were evaluated in our study. All cases of calculous ureteric obstruction who undergone DJ stenting surgical procedure were included in this study. Renal transplant patients, medically unt patients, previous cystectomy and diversion procedures, ureteric strictures were excluded from this study. Data elements extracted from the records such as age, sex, stone size, degree ofhydronephrosis, and creatinine values. Data was analyzed and Chi-square test with Yates correction was used to determine statistical signicance. Results: We observed from our data that factors predicting failure of retrograde DJ stent insertion were large stone (>2cm), severe hydronephrosis and high baseline creatinine levels. Statistically signicant association is noted between large stone size (> 2cm) and failure rate (P-value .00001). After 3 months, creatinine values were normalized (<1.5) in 98 % of unilateral and 69% of bilateral cases. Creatinine values were improved to near normal values in remaining cases. Conclusion: We conclude that stone size>2cm, as an independent signicantly strong predictor of procedural failure. Hence, prompt and early relief of ureteric obstruction restore renal function and reduces morbidity in patients with ureteral obstruction