{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:32:53Z","timestamp":1787761973345,"version":"build-2784847793"},"reference-count":20,"publisher":"Wiley","license":[{"start":{"date-parts":[[2023,2,2]],"date-time":"2023-02-02T00:00:00Z","timestamp":1675296000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Minimally Invasive Surgery"],"published-print":{"date-parts":[[2023,2,2]]},"abstract":"<jats:p>Objective. To identify risk factors for difficult ureters during ureteroscopic lithotripsy and to determine the appropriate indications for preoperative stenting. Methods. We retrospectively analyzed 156 ureteroscopic procedures for upper urinary tract stones after excluding those with preoperative stenting or percutaneous nephrostomy. Traceability of the ureter was assessed by two urologists. Traceability was defined as positive if either or both urologists discerned the ureter in all slices on preoperative plain computed tomography. Patients\u2019 backgrounds were compared between the nondifficult ureter and difficult ureter groups. A multivariate logistic regression model was used to evaluate the relationships between difficult ureters and other clinical factors. Results. Of 156 patients, 31 (19.9%) were classified into the difficult ureter group. The positive traceability was higher in the nondifficult ureter group (48.3% vs. 83.2%, <jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>P<\/a:mi>\n                        <a:mo>&lt;<\/a:mo>\n                        <a:mn>0.001<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>). The major axis was smaller in the difficult ureter group than in the nondifficult ureter group (8.8\u2009\u00b1\u20093.9\u2009mm vs. 10.9\u2009\u00b1\u20094.5\u2009mm, <jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>P<\/c:mi>\n                        <c:mo>&lt;<\/c:mo>\n                        <c:mn>0.018<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula>). A major axis &lt;8\u2009mm (odds ratio: 4.495, 95% confidence interval: 1.791\u201311.278, and <jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>P<\/e:mi>\n                        <e:mo>=<\/e:mo>\n                        <e:mn>0.001<\/e:mn>\n                     <\/e:math>\n                  <\/jats:inline-formula>), negative traceability (odds ratio: 7.565, 95% confidence interval: 2.693\u201321.248, and <jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mi>P<\/g:mi>\n                        <g:mo>&lt;<\/g:mo>\n                        <g:mn>0.001<\/g:mn>\n                     <\/g:math>\n                  <\/jats:inline-formula>), smoking status (odds ratio: 3.196, 95% confidence interval: 1.164\u20138.773, and <jats:inline-formula>\n                     <i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                        <i:mi>P<\/i:mi>\n                        <i:mo>=<\/i:mo>\n                        <i:mn>0.024<\/i:mn>\n                     <\/i:math>\n                  <\/jats:inline-formula>), and absence of diabetes mellitus (odds ratio: 5.813, 95% confidence interval: 1.121\u201330.142, and <jats:inline-formula>\n                     <k:math xmlns:k=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\">\n                        <k:mi>P<\/k:mi>\n                        <k:mo>=<\/k:mo>\n                        <k:mn>0.036<\/k:mn>\n                     <\/k:math>\n                  <\/jats:inline-formula>) were identified as independent predictors of difficult ureters on multivariate logistic regression analysis. Conclusion. Patients with smaller stones, negative traceability, ongoing tobacco consumption, and absence of diabetes mellitus were at higher risk of difficult ureters. In these patients, preoperative stenting may be considered.<\/jats:p>","DOI":"10.1155\/2023\/2584499","type":"journal-article","created":{"date-parts":[[2023,2,2]],"date-time":"2023-02-02T19:50:47Z","timestamp":1675367447000},"page":"1-5","source":"Crossref","is-referenced-by-count":7,"title":["Clinical Factors to Predict Difficult Ureter during Ureteroscopic Lithotripsy"],"prefix":"10.1155","volume":"2023","author":[{"given":"Masashi","family":"Imano","sequence":"first","affiliation":[{"name":"Department of Urology, Yokosuka Kyosai Hospital, 1-6 Yonegaghama-Dori, Yokosuka, Kanagawa, Japan"},{"name":"Department of Urology, National Hospital Organization Yokohama Medical Center, 3-60 Harajuku, Totsuka, Yokohama, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1416-4877","authenticated-orcid":true,"given":"Tadashi","family":"Tabei","sequence":"additional","affiliation":[{"name":"Department of Urology, Yokosuka Kyosai Hospital, 1-6 Yonegaghama-Dori, Yokosuka, Kanagawa, Japan"},{"name":"Department of Urology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Urology, Yokosuka Kyosai Hospital, 1-6 Yonegaghama-Dori, Yokosuka, Kanagawa, Japan"},{"name":"Department of Urology, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junichi","family":"Ota","sequence":"additional","affiliation":[{"name":"Department of Urology, Yokohama Municipal Citizen\u2019s Hospital, 1-1 Mitsuzawa-Nishicho, Kanagawa, Yokohama, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuki","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Urology, Yokosuka Kyosai Hospital, 1-6 Yonegaghama-Dori, Yokosuka, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","article-title":"EAU guidelines on urolithiasis","author":"A. 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