Impact of Diabetes Mellitus on Stone Access and Surgical Outcomes in Patients Undergoing Ureteroscopic Lithotripsy: A Retrospective Cohort Study

Abstract Objectives: 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). Materials and Methods: Between February 2024 and August 2024, a total of 149 patients, including 50 patients with DM (Group 1) and 99 patients without DM (Group 2), were included in the study. 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 diabetes mellitus, 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. Results: There were statistically significant differences between the groups in terms of age, height, BMI and stone volume (p<0.001, p<0.001, p=0.004, p=0.004). The stone access rate was significantly different between the groups (p<0.001), with a higher success rate in group 2 (85.9%) compared to group 1 (58.0%). The stone-free rate was also significantly higher in group 2 (p=0.033). Patients with diabetes mellitus had a significantly lower likelihood of successful stone access, indicating a strong and statistically significant contribution of this variable to the model (p<0.001) Conclusion: Patients with diabetes mellitus have significantly lower stone access rates during URS. In DM patients scheduled for surgery for urolithiasis, considering the possibility of difficult ureters, structuring preoperative evaluation and surgical planning processes accordingly and implementing different preventive strategies if necessary may increase clinical success.