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Measuring individual ureteral length using computed tomography urography to determine the appropriate lengths of ureteral stents
Cheng-Han Tsai1, I-Shen Huang2, Wei-Jen Chen3, Wei-Ming Cheng4, Cheng-Yen Chiang5, Wei-Tang Kao6, Eric Yi-Hsiu Huang3, William J Huang2
1 Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan
2 Department of Urology, Taipei Veterans General Hospital; Department of Physiology; Department of Urology, Shu-Tien Urological Research Center, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
3 Department of Urology, Taipei Veterans General Hospital; Department of Urology, Shu-Tien Urological Research Center, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
4 Department of Urology, Shu-Tien Urological Research Center, College of Medicine, National Yang Ming Chiao Tung University; Division of Urology, Department of Surgery, Taipei City Hospital Zhongxiao Branch, Taipei, Taiwan
5 Surgical Department, Division of Urology, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
6 Department of Urology, Shuang Ho Hospital, Taipei Medical University; Graduate Institute of Clinical Medicine, Taipei Medical University, New Taipei City, Taiwan
Correspondence Address:
Dr. I-Shen Huang
Department of Urology, Taipei Veterans General Hospital, No 201, Section 2, Shipai Road, Taipei 112
Taiwan
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/UROS.UROS_68_21
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Purpose: The purpose of the study was to describe and validate a method for calculating ureteral length using computed tomography (CT) images acquired before ureteral stent placement and to evaluate the appropriateness of fit based on this calculation. Materials and Methods: We analyzed 57 patients who underwent computed tomography urography (CTU). The axial ureteral length (AUL) and coronal ureteral length (CUL) were derived from measurements made on the CTU images, and the length of each patient-specific ureteral stent was chosen based on the calculated ureteral length. Results: Overall, 105 ureters were measured: 54 (51.4%) right side and 51 (48.6%) left side ureters. The mean CUL and AUL of right ureters were 22.5 ± 2.3 cm and 22.5 ± 2.3 cm, respectively, whereas the mean CUL and AUL of left ureters were 23.6 ± 2.2 cm and 23.4 ± 2.1 cm, respectively. Pearson correlation analysis showed that body height was significantly correlated with ureteric length (right CUL and patient height: r =0.441, P = 0.001; right AUL and patient height: R = 0.445, P = 0.001; left CUL: R = 0.341, P = 0.029; left AUL: R = 0.339, P = 0.015). Thirteen of 57 patients underwent ureteral stent insertion; none experienced stent migration (upward or downward) before the removal of the ureteral stent. Comparison of proposed stent size with actual stent size in the 13 patients shows the percentage of size appropriateness (as defined by concordance between proposed and actual stent length) to be 76.9% (10/13). Conclusion: The patient's height was found to correlate significantly with CT-derived measurements of ureteral length. Accordingly, the choice of ureteral stent length can be reliably decided from CT measurements.
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