Risk Factors and Prediction Methods for Endometriosis Combined with Ureteral Stricture Based on Logistic-Regression Analysis.

Objective: This study aimed to explore the risk factors of patients with endometriosis (EMS) and ureteral stricture and to establish a prediction model based on logistic-regression analysis.

Methods: The clinical data of 228 EMS patients in Jiaozhou Central Hospital of Qingdao from May 2019 to May 2022 were selected for a retrospective study. According to the results of ureteroscopic biopsy, they were divided into concurrent (n = 32) and nonconcurrent (n = 196) groups. Univariate analysis was performed on the general data and situations of clinical treatment in both groups. Single factor with statistically significant differences was included in unconditional logistic-regression analysis with multiple factors to explore the risk factors of such patients and establish a prediction model.

Results: Overt differences were found in previous history of ureter operation (odds ratio (OR) = 3.711, = 0.006), course of EMS (OR = 3.987, = 0.007), presence or absence of haematuria (OR = 3.586, = 0.009) and lateral abdominal pain (OR = 4.451, = 0.002), and invasion depth of lesion (OR = 7.271, < 0.001) between the two groups ( < 0.05), without distinct difference in age, menstrual duration, BMI values, history of dysmenorrhea, previous history of drug therapy, smoking history, and drinking history ( > 0.05). Logistic-regression analysis showed that previous history of ureter operation (a1), course of EMS (b2), occurrence of haematuria (c3) and lateral abdominal pain (d4), and invasion depth of lesion ≥5 mm (e5) were risk factors for EMS combined with ureteral stricture ( < 0.05), taking logit () = -4.990 + 1.311a1 + 1.383b2 + 1.277c3 + 1.493d4 + 1.984e5 as regression model. The receiver operating characteristic (ROC) curve analysis based on this model showed that the area under the curve (AUC), standard error, and 95% confidence interval (CI) were 0.813, 0.062, and 0.692-0.934, respectively. One hundred EMS patients were re-included, whose values for predictive sensitivity, specificity, and kappa coefficient were 71.40%, 91.10% and 0.615.

Conclusions: Previous history of ureter operation, course of EMS, occurrence of haematuria and lateral abdominal pain, and invasion depth of lesion ≥5 mm were risk factors for EMS combined with ureteral stricture. Therefore, the use of this model has a certain clinical value.