Long surgical waiting list times are associated with an increased rate of negative ureteroscopies

Authors

  • Daniel A. González-Padilla Department of Urology, University Hospital Infanta Sofía, Madrid, Spain.
  • Alejandro González-Díaz Department of Urology, University Hospital 12 de Octubre, Madrid, Spain.
  • Helena Peña-Vallejo Department of Urology, University Hospital 12 de Octubre, Madrid, Spain.
  • Rocío Santos Pérez de la Blanca Department of Urology, University Hospital 12 de Octubre, Madrid, Spain
  • Julio Teigell-Tobar Department of Urology, University Hospital 12 de Octubre, Madrid, Spain.
  • Mario Hernández-Arroyo Department of Urology, University Hospital 12 de Octubre, Madrid, Spain.
  • Pablo Abad-López Department of Urology, University Hospital 12 de Octubre, Madrid, Spain.
  • Alfredo Rodriguez-Antolin Department of Urology, University Hospital 12 de Octubre, Madrid, Spain.
  • Fernando Cabrera-Meiras Department of Urology, University Hospital 12 de Octubre, Madrid, Spain.

DOI:

https://doi.org/10.5489/cuaj.7199

Keywords:

negative, ureteroscopy, diagnostic, ureterla stone, waiting list, predict

Abstract

Introduction: Negative ureteroscopy (NURS) is “a ureteroscopy in which no stone is found during the procedure.” We aimed to determine the association between the surgical waiting list time (WLT) and the NURS rate.

Methods: We retrospectively analyzed all patients scheduled for ureteroscopy in our center between January 2017 and July 2019. The inclusion criterion was unilateral semirigid ureteroscopy for a single ureteral stone; exclusion criteria were renal-only stones, incomplete ureteroscopy, and stones >10 mm. We analyzed age, gender, body mass index, stone size, density and location, presence of a temporary double-J (DJ) stent, use of medical expulsive therapy, and WLT. Complications while waiting for surgery were also collected and analyzed.

Results: We included 219 patients, 41 (18.7%) of whom had NURS. The median WLT was 74 days (interquartile range [IQR] 45–127). Variables protective against NURS were large stone size (odds ratio [OR] 0.78, 95% confidence interval [CI] 0.66–0.93), presence of a temporary DJ stent (OR 0.43, 95% CI 0.2–0.8), and radiopaque stones (OR 0.44, 95% CI 0.21–0.88). A long WLT (>60 days) increased the risk of NURS (OR 2.18, 95% CI 1.02–4.61). Complications requiring emergency department visits while waiting for surgery were documented in 58/137 (42.3%) patients with indwelling DJ stents; nonetheless, a WLT greater than the median was not associated with an increased risk of complications (p=0.38).

Conclusions: Long WLT has an independent, direct, and linear correlation with NURS rates. Patients at higher risk of NURS, may be offered preoperative re-evaluation with a computed tomography scan in a resource-limited setting.

Downloads

Download data is not yet available.

Downloads

Published

2021-06-22

How to Cite

González-Padilla, D. A., González-Díaz, A., Peña-Vallejo, H., Santos Pérez de la Blanca, R., Teigell-Tobar, J., Hernández-Arroyo, M., Abad-López, P., Rodriguez-Antolin, A., & Cabrera-Meiras, F. (2021). Long surgical waiting list times are associated with an increased rate of negative ureteroscopies. Canadian Urological Association Journal, 15(12). https://doi.org/10.5489/cuaj.7199

Issue

Section

Original Research