Impact of diabetes mellitus on stone access and surgical outcomes in patients undergoing ureteroscopic lithotripsy: a retrospective cohort study

This study aimed to assess the independent effect of diabetes mellitus (DM) on ureteral stone access and surgical outcomes in patients undergoing ureteroscopic lithotripsy (URS). Between February 2024 and August 2024, 149 patients were included in the study: 50 with DM (Group 1) and 99 without DM (Group 2). Patients aged 18 to 80 years who were scheduled for surgery for ureteral calculi in our hospital were included in the study. Patients with any systemic disease other than DM, patients with previous surgery for kidney stones or ureteral calculi, patients undergoing diagnostic URS, pregnant women, patients with oncologic diseases, and patients with one kidney were excluded. There were statistically significant differences between the groups in age, height, BMI, and stone volume (p<0.001, p<0.001, p=0.004, p=0.004, respectively). The rate of successful scope passage to the stone was significantly lower in patients with diabetes mellitus compared to non-diabetic patients (58.0% vs. 85.9%, p<0.001). The stone-free rate was also significantly higher in group 2 (p=0.033). Patients with DM had a significantly lower likelihood of successful scope passage to the stone, indicating a substantial and statistically significant contribution of this variable to the model (p<0.001). Diabetes mellitus was associated with a lower rate of successful scope passage to the stone during ureteroscopic lithotripsy, and this association persisted after multivariable adjustment. However, due to the retrospective design and limited sample size, these findings require confirmation in larger prospective studies.