Yıl: 2024 Cilt: 4 Sayı: 1 Sayfa Aralığı: 19 - 24 Metin Dili: İngilizce DOI: 10.5505/GJU.2024.38257 İndeks Tarihi: 06-02-2024

Effect of the Hounsfield Unit Calculated on the Non-contrast Computed Tomography of Kidney and Ureteral Stones on the Success of Fragmentation with a Holmium: YAG Laser in Ureterorenoscopy and Retrograde Intrarenal Surgery

Öz:
Objective: This study aimed to investigate the effect of stone density on the success of ureterorenoscopy (URS) and retrograde intrarenal surgery (RIRS). Materials and Methods: The data of patients who underwent URS or RIRS due to kidney and ureteral stones between January 2013 and March 2018 were retrospectively screened. For all patients, age, gender, comorbidities, the American Society of Anesthesiologists (ASA) score, the presence of preoperative double-J (DJ) stents, extracorporeal shock wave lithotripsy (ESWL) history, ipsilateral stone surgery history, the presence of renal anomalies, stone laterality, stone opacity, stone density, stone size, stone volume, operative time, stone-free status, and the presence and size of residual stones were recorded. Results: The study included 566 patients who underwent URS or RIRS, including 186 women (32.9%) and 380 (67.1%) men. The mean age of the patients was 47 years. The mean stone size was 10 mm, and the mean stone density was 886 Hounsfield units. The mean stone volume was 426.13 mm3. The mean operative time was 31 minutes. The stone-free rate was 89.4%. Stone density, stone size, and stone volume were positively correlated with operative time (p<0.001) and residual stone size (p<0.001). Additionally, stone density and residual stone size were positively correlated in the group that did not achieve stone-free status (p=0.003). Conclusion: In this study, it was determined that stone density, stone size, and stone volume were positively correlated with residual stone size and operative time. In addition, stone density was positively correlated with residual stone size among patients who were not stonefree after treatment, indicating that high stone density negatively affects the success of treatment even in cases presenting with small stone size and volume preoperatively.
Anahtar Kelime: ureteroscopy retrograde intrarenal surgery stone density stone size stone volume

Böbrek ve Üreter Taşlarının Kontrastsız Bilgisayarlı Tomografi Üzerinde Hesaplanan Hounsfield Ünitesinin Holmium Yag Laser ile Yapılan Üreterorenoskopi ve Retrograd İntrarenal Cerrahi Tedavisinde Fragmantasyon Üzerindeki Etkisi

Öz:
Amaç: Bu çalışmada, taş dansitesinin üreterorenoskopi (URS) ve retrograt intrarenal cerrahi (RIRS) başarısı üzerine etkisini araştırmayı amaçladık. Gereçler ve Yöntemler: Ocak 2013-Mart 2018 tarihleri arasında böbrek ve üreter taşı nedeniyle URS veya RIRS yapılan hastaların verileri retrospektif olarak tarandı. Hastaların yaşı, cinsiyeti, eşlik eden hastalıkları, ASA (American Society of Anesthesiologists) skoru, preoperatif double-J (DJ) stent varlığı, ESWL öyküsü, ipsilateral taş cerrahisi öyküsü, renal anomalinin varlığı, taş lateralitesi, taş opasitesi, taş dansitesi, taş boyutu, taş hacmi, operasyon süresi, taşsızlık durumu ve rezidü taş varlığı kaydedildi. Bulgular: Çalışmamızda 186 kadın (%32.9), 380 (%67.1) erkek olmak üzere URS ve RIRS yapılan 566 hasta mevcuttu. Hastaların yaş ortalaması 47 idi. Hastaların ortalama taş boyutu 10 mm, ortalama taş dansitesi (HU) 886 idi. Ortalama taş hacmi ise 426.13 mm3 ’tü. Ortalama operasyon süresi 31 dakikaydı. Taşsızlık oranı %89.4 idi. Taş dansitesi, taş boyutu ve taş hacminin operasyon süresi (p<0.001) ve rezidü taş (p<0.001) boyutuyla pozitif korele olduğu belirlendi. Ayrıca, stone free olmayan hastalarda taş dansitesi ile rezidü boyutunun pozitif korele olduğu belirlendi (p=0.003). Sonuç: Çalışmamızda taş dansitesi, taş boyutu ve taş hacminin rezidü taş boyutu ve operasyon süresiyle pozitif korele olduğu belirlendi. Ayrıca, stonefree olmayan hastalarda taş dansitesinin rezidü boyutu ile pozitif korele olması yüksek taş dansitesinin taş boyutu ve hacmi düşük olsa dahi taşsızlığı olumsuz etkilediğini göstermektedir.
Anahtar Kelime: üreteroskopi retrograt intrarenal cerrahi taş dansitesi taş boyutu taş hacmi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • [1] EAU 2023 Guidelines on Urolithiasis, Arnhem, The Netherlands: EAU Guidelines Office; n.d.
  • [2] Robertson WG, Peacock M, Baker M, Marshall DH, Pearlman B, Speed R, et al. Studies on the Prevalence and Epidemiology of Urinary Stone Disease in Men in Leeds. Br J Urol. 1983;55(6):595-8. https://doi.org/10.1111/j.1464-410X.1983.tb03383.x
  • [3] Vahlensieck EW, Bach D, Hesse A. Incidence, prevalence and mortality of urolithiasis in the German Federal Republic. Urol Res. 1982;10(4):161-4. https://doi.org/10.1007/BF00255937
  • [4] Akinci M, Esen T, Tellaloglu S. Urinary stone disease in Turkey: An updated epidemiological study. Eur Urol. 1991;20(3):200-3. https://doi.org/10.1159/000471700
  • [5] Wiesenthal JD, Ghiculete D, John D’A Honey R, Pace KT. Evaluating the importance of mean stone density and skin-to-stone distance in predicting successful shock wave lithotripsy of renal and ureteric calculi. Urol Res. 2010;38(4):307-13. https://doi.org/10.1007/s00240-010-0295-0
  • [6] Andrabi Y, Patino M, Das CJ, Eisner B, Sahani D V., Kambadakone A. Advances in CT imaging for urolithiasis. Indian J Urol. 2015;31(3):185-93. https://doi.org/10.4103/0970-1591.156924
  • [7] Gupta NP, Ansari MS, Kesarvani P, Kapoor A, Mukhopadhyay S. Role of computed tomography with no contrast medium enhancement in predicting the outcome of extracorporeal shock wave lithotripsy for urinary calculi. BJU Int. 2005;95(9):1285-8. https://doi.org/10.1111/j.1464-410X.2005.05520.x
  • [8] Yoshida S, Hayashi T, Ikeda J, Yoshinaga A, Ohno R, Ishii N, et al. Role of volume and attenuation value histogram of urinary stone on noncontrast helical computed tomography as predictor of fragility by extracorporeal shock wave lithotripsy. Urology. 2006;68(1):33-7. https://doi.org/10.1016/j.urology.2006.01.052
  • [9] McCarthy CJ, Baliyan V, Kordbacheh H, Sajjad Z, Sahani D, Kambadakone A. Radiology of renal stone disease. Int J Surg. 2016;36(Pt D):638-46. https://doi.org/10.1016/j.ijsu.2016.10.045
  • [10] El-Assmy A, Abou-El-Ghar ME, El-Nahas AR, Refaie HF, Sheir KZ. Multidetector computed tomography: Role in determination of urinary stones composition and disintegration with extracorporeal shock wave lithotripsyan in vitro study. Urology. 2011;77(2):286-90. https://doi.org/10.1016/j.urology.2010.05.021
  • [11] Ito H, Kawahara T, Terao H, Ogawa T, Yao M, Kubota Y, et al. Predictive value of attenuation coefficients measured as hounsfield units on noncontrast computed tomography during flexible ureteroscopy with holmium laser lithotripsy: A single-center experience. J Endourol. 2012;26(9):1125-30. https://doi.org/10.1089/end.2012.0154
  • [12] Gücük A, Üyetürk U, Öztürk U, Kemahli E, Yildiz M, Metin A. Does the hounsfield unit value determined by computed tomography predict the outcome of percutaneous nephrolithotomy? J Endourol. 2012;26(7):792-6. https://doi.org/10.1089/end.2011.0518
  • [13] Hada A, Yadav SS, Tomar V, Priyadarshi S, Agarwal N, Gulani A. Assessment of factors affecting the spontaneous passage of lower ureteric calculus on the basis of lower ureteric calculus diameter, density, and plasma C- reactive protein level. Urol Ann. 2018;10(3):302-7. https://doi.org/10.4103/UA.UA_89_17
  • [14] Erturhan S, Bayrak O, Mete A, Seckiner I, Urgun G, Sarica K. Can the Hounsfield unit predict the success of medically expulsive therapy? J Can Urol Assoc. 2013;7(11-12): E677-80. https://doi.org/10.5489/cuaj.352
  • [15] Hamouche F, Unno R, Hakam N, Charondo LB, Yang H, Ahn J, et al. Clinical and postoperative characteristics of stentless ureteroscopy patients: a prospective analysis from ReSKU. Can J Urol. 2023;30(3):11532-7
  • [16] El-Nahas AR, El-Assmy AM, Mansour O, Sheir KZ. A Prospective Multivariate Analysis of Factors Predicting Stone Disintegration by Extracorporeal Shock Wave Lithotripsy: The Value of High-Resolution Noncontrast Computed Tomography. Eur Urol. 2007;51(6):1688-94. https://doi.org/10.1016/j.eururo.2006.11.048
  • [17] Nakasato T, Morita J, Ogawa Y. Evaluation of Hounsfield Units as a predictive factor for the outcome of extracorporeal shock wave lithotripsy and stone composition. Urolithiasis. 2015;43(1):69-75. https://doi.org/10.1007/s00240-014-0712-x
  • [18] Xiao Y, Li D, Chen L, Xu Y, Zhang D, Shao Y, et al. The R.I.R.S. scoring system: An innovative scoring system for predicting stone-free rate following retrograde intrarenal surgery. BMC Urol. 2017;17(1):105. https://doi.org/10.1186/s12894-017-0297-0
  • [19] Wang C, Wang ST, Wang X, Lu J. External validation of the R.I.R.S. scoring system to predict stone-free rate after retrograde intrarenal surgery. BMC Urol. 2021;21(1):33. https://doi.org/10.1186/s12894-021-00801-y
  • [20] Hori S, Otsuki H, Fujio K, Kobayashi H, Nagao K, Nakajima K, et al. Novel prediction scoring system for simple assessment of stone-free status after flexible ureteroscopy lithotripsy: T.O.HO. score. Int J Urol. 2020;27(9):742-7. https://doi.org/10.1111/iju.14289
  • [21] Senel S, Kasap Y, Kizilkan Y, Tastemur S, Ozden C. External validation of the T.O.HO. score as predictor of success after retrograde intrarenal surgery. BMC Urol. 2022;22(1):68. https://doi.org/10.1186/s12894-022-01018-3
  • [22] Resorlu B, Unsal A, Gulec H, Oztuna D. A new scoring system for predicting stone-free rate after retrograde intrarenal surgery: The “resorlu-Unsal Stone Score.” Urology. 2012;80(3):512-8. https://doi.org/10.1016/j.urology.2012.02.072
  • [23] Baboudjian M, Gondran-Tellier B, Abdallah R, Sichez PC, Akiki A, Gaillet S, et al. Predictive risk factors of urinary tract infection following flexible ureteroscopy despite preoperative precautions to avoid infectious complications. World J Urol. 2020;38(5):1253-9. https://doi.org/10.1007/s00345-019-02891-8
  • [24] Moses RA, Ghali FM, Pais VM, Hyams ES. Unplanned Hospital Return for Infection following Ureteroscopy— Can We Identify Modifiable Risk Factors? J Urol. 2016;195(4 Pt 1):931–6. https://doi.org/10.1016/j.juro.2015.09.074
APA Atar M, turan A, Yilmaz A, YILMAZEL F, karabulut i, SARI S, GUREL A (2024). Effect of the Hounsfield Unit Calculated on the Non-contrast Computed Tomography of Kidney and Ureteral Stones on the Success of Fragmentation with a Holmium: YAG Laser in Ureterorenoscopy and Retrograde Intrarenal Surgery. , 19 - 24. 10.5505/GJU.2024.38257
Chicago Atar Muhittin,turan Abdullah,Yilmaz Ali,YILMAZEL Fatih Kürşat,karabulut ibrahim,SARI SERCAN,GUREL ABDULLAH Effect of the Hounsfield Unit Calculated on the Non-contrast Computed Tomography of Kidney and Ureteral Stones on the Success of Fragmentation with a Holmium: YAG Laser in Ureterorenoscopy and Retrograde Intrarenal Surgery. (2024): 19 - 24. 10.5505/GJU.2024.38257
MLA Atar Muhittin,turan Abdullah,Yilmaz Ali,YILMAZEL Fatih Kürşat,karabulut ibrahim,SARI SERCAN,GUREL ABDULLAH Effect of the Hounsfield Unit Calculated on the Non-contrast Computed Tomography of Kidney and Ureteral Stones on the Success of Fragmentation with a Holmium: YAG Laser in Ureterorenoscopy and Retrograde Intrarenal Surgery. , 2024, ss.19 - 24. 10.5505/GJU.2024.38257
AMA Atar M,turan A,Yilmaz A,YILMAZEL F,karabulut i,SARI S,GUREL A Effect of the Hounsfield Unit Calculated on the Non-contrast Computed Tomography of Kidney and Ureteral Stones on the Success of Fragmentation with a Holmium: YAG Laser in Ureterorenoscopy and Retrograde Intrarenal Surgery. . 2024; 19 - 24. 10.5505/GJU.2024.38257
Vancouver Atar M,turan A,Yilmaz A,YILMAZEL F,karabulut i,SARI S,GUREL A Effect of the Hounsfield Unit Calculated on the Non-contrast Computed Tomography of Kidney and Ureteral Stones on the Success of Fragmentation with a Holmium: YAG Laser in Ureterorenoscopy and Retrograde Intrarenal Surgery. . 2024; 19 - 24. 10.5505/GJU.2024.38257
IEEE Atar M,turan A,Yilmaz A,YILMAZEL F,karabulut i,SARI S,GUREL A "Effect of the Hounsfield Unit Calculated on the Non-contrast Computed Tomography of Kidney and Ureteral Stones on the Success of Fragmentation with a Holmium: YAG Laser in Ureterorenoscopy and Retrograde Intrarenal Surgery." , ss.19 - 24, 2024. 10.5505/GJU.2024.38257
ISNAD Atar, Muhittin vd. "Effect of the Hounsfield Unit Calculated on the Non-contrast Computed Tomography of Kidney and Ureteral Stones on the Success of Fragmentation with a Holmium: YAG Laser in Ureterorenoscopy and Retrograde Intrarenal Surgery". (2024), 19-24. https://doi.org/10.5505/GJU.2024.38257
APA Atar M, turan A, Yilmaz A, YILMAZEL F, karabulut i, SARI S, GUREL A (2024). Effect of the Hounsfield Unit Calculated on the Non-contrast Computed Tomography of Kidney and Ureteral Stones on the Success of Fragmentation with a Holmium: YAG Laser in Ureterorenoscopy and Retrograde Intrarenal Surgery. Grand journal of urology (Online), 4(1), 19 - 24. 10.5505/GJU.2024.38257
Chicago Atar Muhittin,turan Abdullah,Yilmaz Ali,YILMAZEL Fatih Kürşat,karabulut ibrahim,SARI SERCAN,GUREL ABDULLAH Effect of the Hounsfield Unit Calculated on the Non-contrast Computed Tomography of Kidney and Ureteral Stones on the Success of Fragmentation with a Holmium: YAG Laser in Ureterorenoscopy and Retrograde Intrarenal Surgery. Grand journal of urology (Online) 4, no.1 (2024): 19 - 24. 10.5505/GJU.2024.38257
MLA Atar Muhittin,turan Abdullah,Yilmaz Ali,YILMAZEL Fatih Kürşat,karabulut ibrahim,SARI SERCAN,GUREL ABDULLAH Effect of the Hounsfield Unit Calculated on the Non-contrast Computed Tomography of Kidney and Ureteral Stones on the Success of Fragmentation with a Holmium: YAG Laser in Ureterorenoscopy and Retrograde Intrarenal Surgery. Grand journal of urology (Online), vol.4, no.1, 2024, ss.19 - 24. 10.5505/GJU.2024.38257
AMA Atar M,turan A,Yilmaz A,YILMAZEL F,karabulut i,SARI S,GUREL A Effect of the Hounsfield Unit Calculated on the Non-contrast Computed Tomography of Kidney and Ureteral Stones on the Success of Fragmentation with a Holmium: YAG Laser in Ureterorenoscopy and Retrograde Intrarenal Surgery. Grand journal of urology (Online). 2024; 4(1): 19 - 24. 10.5505/GJU.2024.38257
Vancouver Atar M,turan A,Yilmaz A,YILMAZEL F,karabulut i,SARI S,GUREL A Effect of the Hounsfield Unit Calculated on the Non-contrast Computed Tomography of Kidney and Ureteral Stones on the Success of Fragmentation with a Holmium: YAG Laser in Ureterorenoscopy and Retrograde Intrarenal Surgery. Grand journal of urology (Online). 2024; 4(1): 19 - 24. 10.5505/GJU.2024.38257
IEEE Atar M,turan A,Yilmaz A,YILMAZEL F,karabulut i,SARI S,GUREL A "Effect of the Hounsfield Unit Calculated on the Non-contrast Computed Tomography of Kidney and Ureteral Stones on the Success of Fragmentation with a Holmium: YAG Laser in Ureterorenoscopy and Retrograde Intrarenal Surgery." Grand journal of urology (Online), 4, ss.19 - 24, 2024. 10.5505/GJU.2024.38257
ISNAD Atar, Muhittin vd. "Effect of the Hounsfield Unit Calculated on the Non-contrast Computed Tomography of Kidney and Ureteral Stones on the Success of Fragmentation with a Holmium: YAG Laser in Ureterorenoscopy and Retrograde Intrarenal Surgery". Grand journal of urology (Online) 4/1 (2024), 19-24. https://doi.org/10.5505/GJU.2024.38257