https://doi.org/10.4081/aiua.2020.3.244

Non-invasive evaluation of obstruction after ureteroscopic stone removal: Role of renal resistive index assessment

Vol. 92 No. 3 (2020)
Submitted: May 23, 2020
Accepted: June 20, 2020
Published: October 2, 2020
Ureteral obstruction, Resistive index, Renal Doppler ultrasonography
Abstract Views: 842
PDF: 403
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Authors

Bilal Eryildirim
Health Sciences University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
Ahmet Şahan
Health Sciences University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
Özlem Türkoğlu
Health Sciences University, Sultan Abdulhamid Han Training and Research Hospital, Radiology Clinic, Istanbul, Turkey.
Murat Tuncer
Health Sciences University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
Övünç Kavukoğlu
Health Sciences University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
Berkan Şimsek
Health Sciences University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Urology Clinic, Istanbul, Turkey, Turkey.
Alkan Çubuk
alkancubuk@hotmail.com
Health Sciences University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
Kemal Sarica
Biruni University, Medical School, Urology Clinic, Istanbul, Turkey.

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.

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How to Cite

Eryildirim, B., Şahan, A., Türkoğlu, Özlem, Tuncer, M., Kavukoğlu, Övünç, Şimsek, B., Çubuk, A., & Sarica, K. (2020). Non-invasive evaluation of obstruction after ureteroscopic stone removal: Role of renal resistive index assessment. Archivio Italiano Di Urologia E Andrologia, 92(3). https://doi.org/10.4081/aiua.2020.3.244

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