Abstract
Objective: To apply and evaluate the accuracy of the Wang’s nomogram in predicting impacted ureteral stones among patients undergoing ureteroscopic lithotripsy in Vietnam.
Methods: A descriptive study was conducted on 103 patients with ureteral stones who underwent ureteroscopic lithotripsy from February 2023 to February 2024 at the Department of Urology, Hue University of Medicine and Pharmacy Hospital. Patients were recorded on factors related to the Wang’s nomogram including patient age, hydronephrosis, history of ureteral stone intervention, and ureteral wall thickness. At the same time, a number of factors related to impacted ureteral stones were surveyed, including age, gender, BMI, ASA index, etc. Each patient was scored through the Wang’s nomogram (including 4 factors: age, history of ipsilateral ureteral stone treatment, hydronephrosis, and ureteral wall thickness) to estimate the rate of impacted ureteral stones. Impacted ureteral stones were identified during surgery with the diagnostic criteria of failing to pass the guidewire through the stone on the first attempt. Calculate the accuracy, cut-off value, sensitivity, and specificity of the Wang’s nomogram.
Results: 103 patients were included in the study, of which impacted ureteral stones were 47 (45.6%); non-impacted ureteral stones were 56 (54.4%). Factors related to impacted ureteral stones: time of clinical symptoms (p=0.006); maximum cross-sectional area of the stone (p=0.033); stone volume (p=0.003); degree of hydronephrosis (p=0.001); ureteral wall thickness (p<0.0001); ureteral edema (p<0.0001); ureteral polyps (p<0.0001); ureteral adhesion stones (p<0.0001). The Wang’s nomogram has an accuracy of 0.883 (95%CI: 0.810 - 0.956; p<0.0001); the cutoff point of the nomogram is 84.25 points with a sensitivity of 94.4% and a specificity of 72.1%.
Conclusions: With a cut-off point of 84.25, the nomogram allowed prediction of impacted ureteral stones with a sensitivity of 94.4% and a specificity of 72.1%. The Wang’s nomogram is easy to perform and has high accuracy in predicting impacted ureteral stones in the population of patients with ureteral stones in Vietnam.
| Published | 2025-04-24 | |
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| Issue | Vol. 15 No. 1 (2025) | |
| Section | Original Articles | |
| DOI | 10.34071/jmp.2025.1.18 | |
| Keywords | sỏi niệu quản khảm, toán đồ Wang, độ dày thành niệu quản Impacted ureteral stone, Wang’s nomogram, ureteral wall thickness |
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2025 Hue Journal of Medicine and Pharmacy
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