Analysis of Failure Factors in Flexible Ureteroscopy for Upper Ureteral Stones and Comparison with Ureterolithotomy: Development of a Simple Predictive Model

Urology Surgery

Because upper ureteral stones can be challenging in patients, surgeons mainly treat them using Flexible Ureteroscopy (FURL) or Ureterolithotomy. Small stones are usually cleared with FURL so well that patients recover quickly; however, when it comes to larger stones, Ureterolithotomy is a more certain choice. Because careful preoperative planning is essential, proper assessment of a patient's risk ensures better treatment outcomes. However, most past research has assessed how well these practices work, rather than examining when they may not be effective. As a result, it is difficult to choose the most effective treatment plan for a particular patient using data. In this study, we develop and test a model to predict FURL failure and compare Ureterolithotomy and FURL for managing upper ureteral stones. This research evaluates accuracy, the AUC, success rates, and other key parameters to determine the optimal approach. We have developed a model that can predict the likelihood of FURL dysfunction and assist physicians in planning appropriate treatment. To set up the study, researchers looked at patient data about stone size, hydronephrosis grade, and the use of a double-J stent. We designed a logistic regression model to predict rates of FURL failure, achieving an accuracy rate of 85% and an AUC of 0.85, suggesting it could be helpful in preoperative planning. The prediction model supplies vital information for doctors to choose the best treatment for upper ureteral stones in individual patients.

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