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A ureteral stricture disease score and classification system: correlation with upper urinary tract reconstructive
Weijie Zhu1, Zhenpeng Zhu1, Zhihua Li1
1Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China.
Translational Andrology and Urology
|November 22, 2021
Summary
A new Ureteral Stricture Disease (USD) score and classification system was developed to assess ureter stricture complexity. This validated tool aids in surgical planning and comparing minimally invasive upper urinary tract reconstructive (UUTR) procedures.
Area of Science:
- Urology
- Surgical Innovation
- Medical Scoring Systems
Background:
- Ureteral stricture disease (USD) presents challenges in quantifying characteristics and assessing surgical complexity.
- Standardized tools are needed for objective comparisons of minimally invasive upper urinary tract reconstructive (UUTR) procedures.
Purpose of the Study:
- To develop and validate an original, standardized Ureteral Stricture Disease (USD) score and classification system.
- To quantify ureter stricture characteristics and assess the complexity of UUTR surgery.
- To aid in preoperative planning and objective comparison of surgical techniques.
Main Methods:
- Retrospective review of 234 patients undergoing minimally invasive UUTR surgery (January 2018 - January 2021).
- Development of the USD score based on stricture etiology, segment, and length.
- Correlation of USD score with estimated blood loss and operative time as indicators of surgical complexity.
Main Results:
- The USD score demonstrated high interrater reliability (0.908).
- USD scores showed significant linear correlations with estimated blood loss (rs=0.676) and operative time (rs=0.638).
- A significant difference in USD scores was observed between low-complexity (4) and high-complexity (7) UUTR surgery groups (P<0.001).
Conclusions:
- The USD score and classification system is a validated, practical tool for delineating ureteral stricture features and correlating them with UUTR surgical complexity.
- This system facilitates preoperative planning and enhances the comparison of USD treatments in clinical practice and literature.
- Further research with larger sample sizes is recommended to refine the system.
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