Introduction: Recurrent ureteral stricture was relatively common in a small number of patients after upper urinary tract reconstruction. It has been reported that many factors may affect the success rates. However, none of them reached a consensus toward the prediction of ureteral stricture recurrence. The aim was to build a useful and practical nomogram for predicting the recurrence of stricture patients after upper urinary tract reconstitution surgeries. Methods: We studied a retrospective cohort of 237 patients diagnosed with hydronephrosis and received upper urinary tract reconstruction surgery from 2017 to 2021.We developed the nomogram from a derivation cohort including 134 patients from one center. The validation cohort involved 103 patients from other three centers. Results: In the multivariate analysis of the derivation cohort, three candidate predictors were entered into the final prognostic model: the ratio of postoperative urea nitrogen to preoperative urea nitrogen (P=0.026, HR=0.025), time of removing DJ tube after operation (P=0.049, HR=0.234), preoperative severe hydronephrosis (P <0.0001, HR=6.518), which was developed as a best-simplified nomogram for 1-year prognosis, named as HDU. The model had good predictive ability with a C-index of 0.811. The HDU model had an area under the curve of 0.886 in the internal derivation cohort and 0.718 in the external validation cohort. The calibration plots showed a good agreement between the predicted and observed outcomes in both derivation cohort and validation cohort. Conclusions: The nomogram HDU showed good predictive ability through internal validation and external validation, as a methodological exploration on the path to accurate prediction for recurrent stricture after upper urinary tract reconstruction surgery. SOURCE OF Funding: This study was supported by no grants.
