Prediction of the success rates after endoscopic treatment of stone related ureteral stricture: Could the assesement of ureteral wall thickness play a role?

Abstract

Abstract To evaluate the role of certain radiological parameters in predicting the success of endoscopic treatment in ureteral strictures formation. 51 adult patients with ureteral stricture formation (< 1cm) after ureteroscopic removal of proximal ureteric stones were included and in addition to stone and patient parameters, radiological parameters including ureteral wall thickness (UWT) at the impacted stone site were also measured on computed tomography (CT) images. Patients were evaluated in two groups: Group 1: Patients in whom a endoscopic treatment was successful and Group 2: Patients in whom other approaches were needed after endoscopic treatment failure. The possible relationship between the UWT values and other radiological parameter with the outcomes of endoscopic treatment was comparatively evaluated. All patients developed ureteral stricture due to upper ureteral stones with ureteroscopic laser disintegration. No significant difference was present regarding the patient characteristics. Mean UWT value assessed at the treated stone site was significantly higher in cases unresponsive to endoscopic treatment with values of 2.77±1.03 mm and 4.25±1.32 mm in Group 1 and 2 respectively. A cut off value 3.55 mm for UWT was found to be highly predictive for endoscopic treatment failure. Our current results indicated that assessment of UWT value at the obstructing stone could be helpful enough to predict the likelihood of failure following endoscopic management of strictures with high sensitivity and specifity. Evaluation of this particular parameter could let the endourologists to look for more rational treatment alternatives with necessary mesaures taken on time.