Abstract

Introduction

To assess the use of the 2016 proposed classification of the renal papillary abnormalities during flexible ureteroscopy that aims to standardize their description.

Patients and methods

We performed a prospective monocentric single operator collection of the data using this classification during 88 consecutive flexible ureteroscopies required for renal stones treatment. Outcome measurements and statistical analysis: data of stones analysis (microscopy and infrared spectrophotometry) and of serum and urines biochemical samples have been compared with the results of the classified endoscopic descriptions.

Results

Mean duration of description was 81.4 s. We reported that 83% of the patients had Randall plaques (RP), as only 4.5% of the patients had no abnormality. Concerning the papillary stones and anchored stones were observed in 30.7% and aspect of intraductal crystallization (Sc) in 15.9%. Erosions were present in 55.7% and extrophic papillae in 8%. Sa1 and Pa2 were significantly correlated to RP, anchored stones (Sa) to papillary erosions and calcium phosphate stones to intraductal crystallization. Hypercalciuria was significantly higher in Sa2 than Sa1 stones.

Conclusions

The different descriptions in the 2016 classification were confirmed by the results of this study. Papillary abnormalities are consequences of stones development. Their descriptions could also improve the follow-up and the diagnosis of a metabolic lithogenesis. We recommend their systematic description during ureteroscopy. Some improvements are proposed to update this classification.

中文翻译：

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输尿管软镜下肾乳头异常分类：2016版评价及更新。

摘要

介绍

评估 2016 年提出的肾乳头异常分类在输尿管软镜检查中的使用，旨在标准化其描述。

患者和方法

在肾结石治疗所需的 88 次连续柔性输尿管镜检查中，我们使用该分类对数据进行了前瞻性单中心单操作员收集。结果测量和统计分析：将结石分析（显微镜和红外分光光度法）以及血清和尿液生化样本的数据与分类内镜描述的结果进行了比较。

结果

描述的平均持续时间为 81.4 秒。我们报告了 83% 的患者有兰德尔斑块 (RP)，因为只有 4.5% 的患者没有异常。乳头状结石和锚定性结石占 30.7%，导管内结晶 (Sc) 占 15.9%。55.7% 存在糜烂，8% 存在外突乳头。Sa1 和 Pa2 与 RP 显着相关，锚定结石 (Sa) 与乳头状侵蚀显着相关，磷酸钙结石与导管内结晶显着相关。Sa2 结石的高钙尿症明显高于 Sa1 结石。

结论

本研究结果证实了 2016 年分类中的不同描述。乳头异常是结石发展的后果。他们的描述还可以改善代谢成石的随访和诊断。我们建议在输尿管镜检查期间对其进行系统描述。提出了一些改进来更新这个分类。