The Role of Preoperative Ureteral Diameter Measurements in Predicting Difficult Access During Retrograde Intrarenal Surgery: A Retrospective Analysis of 234 Patients

Completed

• Conditions: Kidney Stones; Retrograde Intrarenal Surgery; Difficult Ureteral Access Prediction

• Registration Number: NCT06746779
• Lead Sponsor: Hisar Intercontinental Hospital

Brief Summary

This study investigates the role of preoperative ureteral diameter measurements in predicting difficult access during retrograde intrarenal surgery (RIRS) in patients with kidney stones. A retrospective analysis was conducted on 234 patients who underwent RIRS, evaluating factors such as preoperative ureteral diameters (measured at distal, iliac, and upper ureteral levels via CT scans), stone size, patient demographics, operation duration, and surgical success rates. The findings aim to determine whether ureteral diameter measurements can serve as reliable predictors for surgical challenges, ultimately improving preoperative planning and patient outcomes.

Detailed Description

This retrospective study evaluates the role of preoperative ureteral diameter measurements in predicting difficult access during retrograde intrarenal surgery (RIRS) in patients with kidney stones. A total of 234 patients who underwent RIRS were included in the analysis. Preoperative computed tomography (CT) scans were used to measure ureteral diameters at three levels: distal ureter, iliac ureter, and upper ureter. The relationship between ureteral diameter and intraoperative access difficulty was assessed.

The study also analyzed patient demographics (age, gender, BMI), stone characteristics (size, location), operative parameters (duration, access attempts), and outcomes (surgical success and complication rates). Difficult access during RIRS was defined based on the number of attempts required to achieve successful ureteral access, need for secondary procedures, or inability to complete the planned surgery.

The primary aim was to determine whether preoperative ureteral diameter measurements can serve as predictive markers for challenging surgical access. Secondary objectives included identifying other patient or stone-related factors contributing to access difficulty and evaluating their impact on surgical outcomes. The findings may assist clinicians in preoperative planning, improving patient selection for RIRS, and optimizing intraoperative strategies to minimize complications and enhance procedural success rates.

Study Timeline

• Study Start: 2018-01-01
• Primary Completion: 2022-12-31
• Status Verified: 2024-12
• Study Completion: 2024-12-10
• Study First Submitted: 2024-12-18
• Study First Submitted QC: 2024-12-18
• Last Update Submitted: 2024-12-21
• Study First Posted: 2024-12-24
• Last Update Posted: 2024-12-27

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 234

Inclusion Criteria

Patients aged 18 years or older. Diagnosed with kidney stones (nephrolithiasis) requiring surgical intervention. Underwent retrograde intrarenal surgery (RIRS). Available preoperative CT scans for ureteral diameter measurements. Complete medical records, including demographic, clinical, and surgical data.

Exclusion Criteria

History of open or laparoscopic renal surgery. Presence of ureteral strictures or congenital anomalies. Patients with incomplete or missing medical records. Active urinary tract infection at the time of surgery. Pregnant or lactating individuals.

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Predictive Value of Preoperative Ureteral Diameter for Difficult Access During RIRS	Intraoperative (assessed during the surgical procedure).	Evaluate the correlation between preoperative ureteral diameters (measured at distal, iliac, and upper ureteral levels via CT imaging) and the difficulty of achieving ureteral access during retrograde intrarenal surgery (RIRS).

Trial Locations

Locations (2)

Basri Cakiroglu; 🇹🇷 Istanbul, Turkey

Hisar Intercontinental Hospital; 🇹🇷 Istanbul, Turkey