Evaluation of Postoperative Hydronephrosis Following Ureteroscopy in Pediatric Population: Incidence and Predictors

• Published in: Urology (Ridgewood, N.J.) Vol. 93; pp. 164 - 169
• Main Authors: Gökce, Mehmet Ilker, Telli, Onur, Özkıdık, Mete, Akıncı, Aykut, Hajıyev, Perviz, Soygür, Tarkan, Burgu, Berk
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2016
• Subjects: Child; Female; Humans; Hydronephrosis - epidemiology; Incidence; Kidney Calculi - surgery; Male; Postoperative Complications - epidemiology; Retrospective Studies; Ureteral Calculi - surgery; Ureteroscopy; Urology
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2016.02.052

Objective To identify the incidence and associated factors of the postoperative hydronephrosis in pediatric patients who underwent ureterorenoscopy (URS) for renal or ureteral stones. Patients and Methods We evaluated the results of 116 patients who underwent semirigid or flexible URS retrospectively. Primary end points of the study were to determine the incidence of postoperative hydronephrosis and factors associated with the development of postoperative hydronephrosis. Logistic regression analysis was used to define factors associated with the presence of hydronephrosis. Results Mean age of the population was 9.5 years and mean stone size was 9.4 mm. Hydronephrosis was detected in 32 (27.6%) patients. Stone-free status was achieved in 101 (87%) patients. Univariate analysis revealed history of ipsilateral URS, duration of operation, presence of impacted stone, development of ureteral injury during operation, and presentation with a renal colic episode as the parameter associated with increased risk of hydronephrosis. History of ipsilateral URS (odds ratio: 1.664, P  = .027), presence of impacted stones (odds ratio: 1.788, P  = .014), and development of ureteral injury during operation (odds ratio: 1.106, P  = .039) were found to be the independent markers of developing postoperative hydronephrosis in a multivariate analysis. Conclusion Ipsilateral hydronephrosis following URS develops in a significant portion of patients. In patients with history of ipsilateral procedure and those with an impacted stone and had ureteral injury, the risk of postoperative hydronephrosis is higher; therefore, physicians should keep these parameters in mind in the decision-making process of selective imaging postoperatively.