Factors Affecting the Complications of Pneumatic Lithotripsy for the Treatment of Ureteral Stones with Different Localizations: A Multivariate Analysis of Complications

Abstract

OBJECTIVE: To evaluate the complications of ureterorenoscopy (URS) using the modified Clavien classification system for ureteral stones with different localizations. PATIENTS AND METHODS: From February 2001 to January 2010, a total of 1,926 patients underwent URS for the treatment of ureteral stones with different localizations. The complications were evaluated according to the modified Clavien system. Univariate and multivariate analyses were conducted to identify risk factors affecting the complication rates. RESULTS: The patient cohort included 1,212 males and 714 females with a mean age of 47.8 ± 14.3 years (range 15-86). The success rate was 95.7%. The overall complication rate was 9.3%. Univariate analysis revealed that solitary kidney, stone burden, bilaterality, stone localization (proximal to the iliac crest) and stone impaction significantly affected the complication rates. Multivariate analysis revealed that preoperative shock wave lithotripsy treatment, stone impaction, multiplicity, proximal localization and stone burden were significant parameters affecting the occurrence of complications (relative risks of 6.5, 4.3, 3.3, 2.4 and 2.0, respectively). CONCLUSIONS: URS is a safe and minimally invasive procedure with a high success rate and low-grade, self-limiting complications. Preoperative shock wave lithotripsy treatment, stone impaction, multiplicity, proximal localization and stone burden were independent risk factors for the development of complications.