{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T12:09:56Z","timestamp":1791634196962,"version":"4.3.4"},"reference-count":24,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,7,25]],"date-time":"2023-07-25T00:00:00Z","timestamp":1690243200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Urologia"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec><jats:title>Objectives:<\/jats:title><jats:p> To verify if the maximum thickness of the ureteral wall at the stone site (m-UWT) can affect the outcomes of primary retrograde ureteroscopic lithotripsy (P-URSL) within a single-center dataset. <\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods:<\/jats:title><jats:p> We retrospectively reviewed data on 354 consecutive URSL performed from January 2020 to May 2022 at \u201cFondazione Poliambulanza\u201d in Brescia (Italy). We included patients older than 18\u2009years who underwent URSL for a single ureteral stone with a maximum diameter ranging from 5 to 10\u2009mm. Patients with anatomical abnormalities, a positive preoperative urinary culture, or without a NCCT performed during the acute event were excluded. Patients were treated in an emergency setting (P-URSL within 48\u2009h from the diagnosis of acute ureteral colic) or in a delayed one (D-URSL after a period of maximum 90\u2009days of ureteral double-j stenting). For the resulting 139 patients we recorded demographic, clinical and stone-related features and perioperative data. We processed these data by univariate and multivariate analysis, and with a logistic regression analysis. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> Of the 139 included procedures, 63 were P-URSL and 76 D-URSL. At the univariate analysis we found that stone diameter (OR 0.845, p\u2009=\u20090.017), stone volume (OR 0.023, p\u2009=\u20090.001), stone density (OR 0.998, p\u2009=\u20090.000) and m-UWT (OR 0.499, p\u2009=\u20090.013) are predictors of P-URSL. Stone density (OR 0.998, p\u2009=\u20090.002) is an independent predictor of P-URSL at the multivariate analysis. At a logistic regression analysis, a distal ureteric position (OR 0.189, p\u2009=\u20090.014), stone diameter (OR 1.289, p\u2009=\u20090.006), and m-UWT (OR 2.297, p\u2009=\u20090.02) were found to be statistically significant predictors of incomplete stone clearance in patients undergoing P-URSL. m-UWT is the only predictor of short-term postoperative adverse events in patients undergoing P-URSL (OR 3.386, p\u2009&lt;\u20090.001). From a descriptive analysis, it emerged that an increased m-UWT (&gt;2\u2009mm) significantly correlates to an endoscopic finding of ureteritis\u2019 signs and to an increase in operative time, hospital stay and post-procedural stenting time. A m-UWT greater than 2\u2009mm also correlates with a lower stone free rate (SFR) and with a significant increase in both short and long-term postoperative complications. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p> Our study confirmed a connection between m-UWT and poor endoscopic findings, as well as a direct correlation with the main morphometric parameters of the stone and finally with the outcomes of P-URSL itself. Further studies are necessary to validate our results, so that m-UWT might be routinely considered a useful tool in the decision-making process for P-URSL. <\/jats:p><\/jats:sec>","DOI":"10.1177\/03915603231189618","type":"journal-article","created":{"date-parts":[[2023,7,26]],"date-time":"2023-07-26T06:52:06Z","timestamp":1690354326000},"page":"117-124","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Outcomes of primary ureteroscopic lithotripsy: The role of maximum ureteral wall thickness at the site of stone impaction"],"prefix":"10.1177","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4958-3780","authenticated-orcid":false,"given":"Tonino","family":"Morena","sequence":"first","affiliation":[{"name":"Urology Unit, Fondazione Poliambulanza Hospital, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9303-049X","authenticated-orcid":false,"given":"Andrea","family":"Vismara Fugini","sequence":"additional","affiliation":[{"name":"Urology Unit, Fondazione Poliambulanza Hospital, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5947-3206","authenticated-orcid":false,"given":"Alessandro","family":"Veccia","sequence":"additional","affiliation":[{"name":"Urology Unit, AUOI Verona, University of Verona, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Riva","sequence":"additional","affiliation":[{"name":"Urology Unit, Fondazione Poliambulanza Hospital, Brescia, Italy"},{"name":"Urology Unit, ASST Spedali Civili Hospital, University of Brescia, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Peroni","sequence":"additional","affiliation":[{"name":"Urology Unit, Fondazione Poliambulanza Hospital, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,7,25]]},"reference":[{"key":"bibr1-03915603231189618","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.13251215"},{"key":"bibr2-03915603231189618","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e5499"},{"issue":"3","key":"bibr3-03915603231189618","first-page":"29","volume":"101","author":"Ramos-Fern\u00e1ndez M","year":"2009","journal-title":"Bol Asoc Med P 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