Ureteroscopic lithotripsy combined with stent placement contributed to long-term auto-release of lithangiuria in upper urinary tract after ureterolithotripsy

Abstract Background To investigate the clinical efficiency of ureterectasis combined with stent placement in the long-term auto-release of lithangiuria in upper urinary tract after ureterolithotripsy. Methods In this retrospective analysis, we included the patients (male: 314; female: 49; age: 32–78 yrs; median age: 53 yrs) admitted to our hospital between January 2014 and January 2018 underwent ureterolithotripsy (URS group, n = 178) and extracorporeal shock wave lithotripsy (ESWL group, n = 212) for treating lithangiuria in upper urinary tract. All the patients were followed up for 24–59 months after treatment (median: 38 months). Uni-variate and multi-variate Logistic regression analysis was used to analyze the factors that could affect the long-term release of lithangiuria in upper urinary tract. Then we compared the short diameter of the ureter surpassing the stenosis of iliac vessels and the long-term auto-release of lithotripsy between the two groups. Results Logistic regression analysis indicated that the risk of auto-release of the stones in the upper urinary tract in the URS group was significantly higher than that of the ESWL group (OR = 3.357, 95% CI: 1.234–9.137). Stent placement was an independent risk factor for long-term auto-release of lithotripsy (P < 0.01). The short diameter of the ureter surpassing the stenosis of iliac vessels after URS was significantly longer than that of the baseline level (6.06 ± 1.26 mm vs. 3.63 ± 0.98 mm, t = 20.88, P < 0.01). The short diameter of the ureter surpassing the stenosis of iliac vessels after ESWL showed no statistical differences compared with that of the baseline level (3.67 ± 1.02 mm vs. 3.61 ± 0.94 mm, t=-0.798, P = 0.425). Sixteen cases (2.8%) in the URS group showed auto-release of stones during the follow-up, which was significantly higher than that in the ESWL group with 6 cases (13.5%) presented auto-release of stones (χ2 = 6.895, P = 0.09). Conclusions The combination of URS and stent replacement induced obvious ureterctasis, which may contribute to the auto-release of stones in the upper urinary tract in the long-term.