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To evaluate the possible role of ureteral wall thickness (UWT) assessment in the prediction of the success for stent placement in cases with obstructing ureteric stones. 227 adult patients with a single unilateral obstructing ureteral stone requiring internal ureteral stent placement were included. In addition to stone size, the ureteric wall thickness at the impacted stone site and the degree of hydronephrosis were also assigned on CT images. Patients were divided into two subgroups: Group 1: patients in whom internal ureteral stent could not be passed beyond the stone and Group 2: patients in whom an internal ureteral stent was passed successfully. The possible relationship between the UWT values and the success of stent placement, degree of hydronephrosis were comparatively evaluated. The majority of the stones were located in the proximal ureter in Group 1 and the degree of hydronephrosis was also higher in these cases. Moreover, while the mean value of UWT calculated on CT images was 4.3 ± 0.9 mm in Group 1, this value was noted to be 2.5 ± 0.8 mm in cases of group 2. A cutoff UWT value of 3.35 mm was highly predictive for the stent insertion and cases with higher values required additional procedures or percutaneous nephrostomy tube placement. UWT value calculated at the obstructing stone site was found to be predictive enough for the likelihood of internal ureteral stent passage with high sensitivity and specificity. This evaluation may enable the urologist to make the best decision for urinary diversion in such cases. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study is to evaluate prediction of postoperative ureteral obstruction needing ureteral stent insertion by evaluating the resistive index (RI) values and the grade of hydronephrosis. Material and Methods: A total of 66 adult patients undergoing stentless endoscopic ureteral stone treatment (URS) between January 2018 and January 2019 were included in this prospective study. Preoperative patient and stone characteristics were noted. All patients were evaluated with renal Doppler ultrasonography study to assess degree of hydronephrosis and RI values. A renal Doppler ultrasonography was repeated at postoperative 1st, 3rd and 7th days. Changes in both RI and hydronephrosis levels before and after the procedures were noted. On the postoperative 7th day, patients were divided into two groups including obstructive and non-obstructive cases according to RI values assessed where a RI value of 0.7 was accepted as the cut-off for obstruction. The preoperative and perioperative characteristics of both groups were evaluated in a comparative manner. Results: The mean patient age was 43.6 ± 1.72 years. Significant improvements were noted in RI and grade of hydronephrosis after the operation. The grade of hydronephrosis and RI values were found to improve more significantly on postoperative 3rd day when compared to the postoperative 7th day (p < 0.01 and p < 0.01). A significant correlation was detected between the grade of hydronephrosis (>grade 2) and obstructive RI values (> 0.7) in each postoperative visits (p: 0.001). RI values (> 0.7) at postoperative seventh days were correlated with larger mean stone size, increased ureteral wall thickness, increased diameter of the ureter proximal to the stone, and longer duration of the operation. Preoperative high-grade hydronephrosis indicated obstructive RI values at postoperative seventh day (p = 0.001) Conclusion: Changes in RI values on Doppler sonography and the grade of hydronephrosis may be a guiding parameter in assessing postoperative ureteral obstruction. [ABSTRACT FROM AUTHOR]

Purpose: Ureteric stents are frequently used in urology practice and can cause significant impairment in quality of life (QoL). The aim of this study was to validate the Ureteral Stent Symptoms Questionnaire (USSQ) to be used in the evaluation of stent-related symptoms and impairment in QoL in Turkish-speaking patients. Methods: After linguistic validation of the original USSQ into Turkish language, the Turkish version of the USSQ (T-USSQ) was self-administered to all participants at week 1 and 4 after stent placement for test-retest reliability and internal consistency and at week 8 (4 weeks after stent removal) for sensitivity to change analysis. Control patients completed the form only once. Additionally male and female patients completed the validated Turkish versions of International Prostate Symptom Score (IPSS) and Marmara Overactive Bladder (mOAB) Symptom Scores, respectively. Results: A total of 68 patients with ureteral stents and 37 controls were available for the final analysis. The Cronbach's alpha value was higher than 0.7 at week 1 for all sub-domains except additional problems domain. The test-retest reliability of the T-USSQ was high for all sub-domains except the additional problems domain. Relatively high correlation coefficients were found for the visual analog scale for pain, IPSS (for males), mOAB score (for females) with the corresponding USSQ domains, suggesting good convergent validity. Also the T-USSQ could effectively differentiate between patients and controls. Conclusions: The T-USSQ is a reliable and robust instrument that can be self-administered to patients of Turkish population with ureteral stent in the clinical applications. [ABSTRACT FROM AUTHOR]