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Newly Developed Hydronephrosis in Patients Following Ureteroscopy: Who Is at Risk?
Golena Fernandez Moncaleano1, Sabir Meah1, Suprita Krishna1
1Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.
Journal of Endourology
|August 9, 2025
Summary
New postoperative hydronephrosis affects about 8% of patients after ureteroscopy. Most cases are temporary, and silent hydronephrosis is rare, suggesting a targeted imaging approach is best.
Area of Science:
- Urology
- Nephrology
- Medical Imaging
Background:
- Low imaging rates post-ureteroscopy in the US.
- Detecting postoperative hydronephrosis is crucial for patient care.
- Identifying at-risk patients can guide imaging protocols.
Purpose of the Study:
- To analyze new-onset postoperative hydronephrosis after ureteroscopy for urolithiasis.
- To identify associated risk factors for new postoperative hydronephrosis.
- To inform imaging guidelines following ureteroscopy.
Main Methods:
- Retrospective analysis of ureteroscopy cases from a clinical registry (July 2020-June 2023).
- Inclusion of patients without preoperative hydronephrosis.
- Definition of new postoperative hydronephrosis as findings between postoperative days 29-60.
Main Results:
- 8.2% of patients (87/1066) developed new postoperative hydronephrosis.
- Over half (58.6%) of these cases were transient.
- Renal stone location was an independent predictor of postoperative hydronephrosis.
Conclusions:
- Postoperative hydronephrosis occurs in approximately 1 in 13 patients with pre- and post-operative imaging after ureteroscopy.
- Transient hydronephrosis is common, while silent cases are infrequent.
- A goal-directed, rather than routine, imaging strategy is supported by these findings.
Keywords:
kidney stoneslithotripsypostoperative hydronephrosissilent hydronephrosisureteroscopyurolithiasisMore Related Videos
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