{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:32:15Z","timestamp":1786739535477,"version":"build-2736575974"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","license":[{"start":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:00:00Z","timestamp":1733011200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Urologists can encounter difficulties when dealing with ureteral stone impaction. However, reliable preoperative indicators of stone impaction are scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>We aimed to determine ureteral wall thickness (UWT) as an independent predictor of intraoperative stone impaction, to detect if any patient or stone-related factors predict impaction and to ascertain whether impaction affected intraoperative\/postoperative outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We prospectively studied 83 patients who underwent ureterorenoscopic lithotripsy for ureteral stones between October 2023 and March 2024. UWT measurement was done preoperatively on non-contrast computed tomography. Clinical predictors of stone impaction were analyzed by univariate and multivariate analyses. Receiver operator characteristic (ROC) curve analysis was performed to identify the optimal cutoff for independently predicting impaction. We also analyzed intraoperative and postoperative outcomes with respect to impaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Out of 83 patients, 46 (55.42%) had impacted stones. Gender, stone laterality, stone size, area, Hounsfield unit, degree of hydronephrosis, duration of symptoms, and UWT had significant association with stone impaction on univariate analysis. When these factors were subjected to multivariate analysis, only UWT and stone area had significant association with impaction. We determined a UWT cutoff of 3.45 mm and a stone area cutoff of 28.62 mm\n                      <jats:sup>2<\/jats:sup>\n                      for predicting impaction based on ROC analysis. Our study showed that impaction increased the overall duration of the procedure and affected stone clearance rates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Based on our study, high UWT is associated with a higher risk of stone impaction, prolonged duration of procedure, and lower stone clearance rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/njcp.njcp_405_24","type":"journal-article","created":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T01:00:41Z","timestamp":1741050041000},"page":"1456-1463","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Ureteral Wall Thickness as an Independent Predictor of Stone Impaction \u2013 A Prospective, Single-Center, Observational Study"],"prefix":"10.4103","volume":"27","author":[{"given":"FB","family":"Daniel","sequence":"first","affiliation":[{"name":"Department of Urology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Palaniyandi","sequence":"additional","affiliation":[{"name":"Department of Urology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Kumaresan","sequence":"additional","affiliation":[{"name":"Department of Urology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Krishnamoorthy","sequence":"additional","affiliation":[{"name":"Department of Urology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Thiruvengadam","sequence":"additional","affiliation":[{"name":"Department of Urology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,3,4]]},"reference":[{"key":"R1-20260423","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/S0022-5347(17)39928-7","article-title":"Management of the impacted ureteral calculus","volume":"143","author":"Morgentaler","year":"1990","journal-title":"J Urol"},{"key":"R2-20260423","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1046\/j.1442-2042.1999.00067.x","article-title":"Characterization of ureteral lesions associated with impacted stones","volume":"6","author":"Yamaguchi","year":"1999","journal-title":"Int J Urol"},{"key":"R3-20260423","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1016\/S0022-5347(01)63711-X","article-title":"Ureteral stricture formation after removal of impacted calculi","volume":"159","author":"Roberts","year":"1998","journal-title":"J Urol Mar"},{"key":"R4-20260423","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1097\/01.ju.0000100960.08768.81","article-title":"Endoscopic features of impacted ureteral stones","volume":"171","author":"Mugiya","year":"2004","journal-title":"J Urol"},{"key":"R5-20260423","doi-asserted-by":"crossref","first-page":"339","DOI":"10.4111\/icu.2017.58.5.339","article-title":"Radiological non-invasive assessment of ureteral stone impaction into the ureteral wall: A critical evaluation with objective radiological parameters","volume":"58","author":"Elibol","year":"2017","journal-title":"Investig Clin Urol"},{"key":"R6-20260423","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.urology.2019.04.020","article-title":"Predicting the impacted ureteral stone with computed tomography","volume":"130","author":"Tran","year":"2019","journal-title":"Urology"},{"key":"R7-20260423","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1007\/s00240-023-01526-3","article-title":"Area of hydronephrosis is a useful predictive factor of impacted ureteral stones","volume":"52","author":"Iwahashi","year":"2024","journal-title":"Urolithiasis"},{"key":"R8-20260423","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.urology.2013.09.037","article-title":"Measurement of ureteric stone diameter in different planes on multidetector computed tomography-impact on the clinical decision making","volume":"83","author":"Nazim","year":"2014","journal-title":"Urology"},{"key":"R9-20260423","doi-asserted-by":"crossref","first-page":"W548","DOI":"10.2214\/AJR.11.8462","article-title":"What the radiologist needs to know about urolithiasis; Part 2 - CT findings, reporting and treatment","volume":"198","author":"Cheng","year":"2012","journal-title":"AJR Am J Roentgenol"},{"key":"R10-20260423","first-page":"72","article-title":"Presence of transient hydronephrosis immediately after surgery has a limited influence on renal function 1 year after ileal neobladder construction","volume":"70","author":"Takuma","year":"2017","journal-title":"BMC Urol"},{"key":"R11-20260423","first-page":"e35972","article-title":"A Prospective evaluation of association of ureteral wall thickness with intraoperative stone impaction in ureteroscopy","volume":"15","author":"Rasheed","year":"2023","journal-title":"Cureus"},{"key":"R12-20260423","doi-asserted-by":"crossref","first-page":"119","DOI":"10.4103\/0970-1591.32059","article-title":"Role of non-contrast spiral computerized tomography in acute ureteric colic","volume":"23","author":"Feroze","year":"2007","journal-title":"Indian J Urol"},{"key":"R13-20260423","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1259\/bjr\/62994625","article-title":"Emergency department imaging protocol for suspected acute renal colic: Re-evaluating our service","volume":"85","author":"Patatas","year":"2021","journal-title":"Br J Radiol"},{"key":"R14-20260423","doi-asserted-by":"crossref","first-page":"2418","DOI":"10.1016\/j.juro.2007.09.107","article-title":"EAU\/AUA Nephrolithiasis Guideline Panel. 2007 guideline for the management of ureteral calculi","volume":"178","author":"Preminger","year":"2007","journal-title":"J Urol"},{"key":"R15-20260423","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1148\/rg.303095146","article-title":"New and evolving concepts in the imaging and management of urolithiasis: Urologists\u2019 perspective","volume":"30","author":"Kambadakone","year":"2010","journal-title":"Radiographics"},{"key":"R16-20260423","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1016\/j.urology.2012.05.007","article-title":"Outcomes of ureteroscopy for management of impacted ureteral calculi with different localizations","volume":"80","author":"Degirmenci","year":"2012","journal-title":"Urology"},{"key":"R17-20260423","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1159\/000343668","article-title":"Experience of mini-percutaneous nephrolithotomy in the treatment of large impacted proximal ureteral stones","volume":"90","author":"Long","year":"2013","journal-title":"Urol Int"},{"key":"R18-20260423","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1007\/s00345-018-2461-x","article-title":"Ureteral wall thickness as a significant factor in predicting spontaneous passage of ureteral stones of \u226410 mm: A preliminary report","volume":"37","author":"Yoshida","year":"2019","journal-title":"World J Urol"},{"key":"R19-20260423","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.urology.2017.04.047","article-title":"Ureteral wall thickness as a preoperative indicator of impacted stones in patients with ureteral stones undergoing ureteroscopic lithotripsy","volume":"106","author":"Yoshida","year":"2017","journal-title":"Urology"},{"key":"R20-20260423","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s00240-014-0724-6","article-title":"Ureteral wall thickness at the impacted ureteral stone site: A critical predictor for success rates after SWL","volume":"43","author":"Sarica","year":"2015","journal-title":"Urolithiasis"},{"key":"R21-20260423","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1016\/j.jpurol.2021.10.005","article-title":"Ureteral wall thickness at the stone site: A critical predictor of success and complications in children undergoing semi-rigid ureteroscopy","volume":"17","author":"Kirli","year":"2021","journal-title":"J Pediatric Urol"},{"key":"R22-20260423","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1503\/cmaj.090371","article-title":"Allergic-type reactions to radiographic contrast media","volume":"182","author":"Baerlocher","year":"2010","journal-title":"CMAJ"},{"key":"R23-20260423","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1159\/000452926","article-title":"Semi-rigid ureteroscopy for proximal ureteral stones: Does adjunctive tamsulosin therapy increase the chance of success?","volume":"98","author":"Ahmed","year":"2017","journal-title":"Urol Int"},{"key":"R24-20260423","doi-asserted-by":"crossref","first-page":"112","DOI":"10.5144\/0256-4947.2016.112","article-title":"Iatrogenic submucosal tunnel in the ureter: A rare complication during advancement of the guide wire","volume":"36","author":"El Darawany","year":"2016","journal-title":"Ann Saudi Med"},{"key":"R25-20260423","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1007\/s00345-017-2028-2","article-title":"Characteristics and outcomes of ureteroscopic treatment in 2650 patients with impacted ureteral stones","volume":"35","author":"Jaap","year":"2017","journal-title":"World J Urol"}],"container-title":["Nigerian Journal of Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/njcp.njcp_405_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T19:29:47Z","timestamp":1786735787000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/njcp.njcp_405_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":25,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/njcp.njcp_405_24","relation":{},"ISSN":["1119-3077","2229-7731"],"issn-type":[{"value":"1119-3077","type":"print"},{"value":"2229-7731","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12]]},"assertion":[{"value":"2024-06-22","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-15","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}