Predictors of access failure in patients undergoing ureteroscopy for ureteric calculi
Ammar Fadil Abid, Bairq A. Mahdi, Ahmed HazimAbstract
Introduction:
The term failed access (FA) ureteroscopy (URS) refers to the situation where a stone cannot be adequately accessed to facilitate treatment. Finding the risk factors for FA in individuals presenting with ureteral stones was the aim of this investigation.
Aim of the Study:
The aim of the study was to determine the predictors of access failure in patients undergoing URS for ureteric calculi in the adult group.
Study Design:
A clinical retrospective and prospective study of 316 ureteroscopic cases done between January 2021 to August 2024 at Al-Yarmouk Urology Center and a private hospital.
Patients and Methods:
Patients performed URS procedures for ureteral stones. We reviewed all these procedures. Included were all individuals who received a ureteroscope to cure stones. Failure access was examined with respect to demographics, medical history, features unique to stones, and features unique to procedures using SPSS statistical software version 29.0.
Results:
The age ranged from 18 to 82 years (mean age 42.8 ± 12.7 years); 152 were males (51.1%) and 148 were females (49.3%). 316 cases of ureteroscopes in all were examined, and the failure access rate was 8%. There were no significant differences seen between the groups receiving FA and successful access (SA) in terms of patient age, gender, body mass index (BMI), prior stone treatment, presence of hydronephrosis, and stone size. However, there was a significant difference between the FA and SA groups in terms of density of stone ≥600 (HU) (95.8 FA vs. 67.0 SA,
Conclusions:
Access failure was more likely to occur in proximal ureteric stones, impacted stones, high stone density, and smoker patients. Staged procedures might be required. The data from this study will assist urologists in preoperatively counseling patients on the possibility of access failure.