Complications of 2735 Retrograde Semirigid Ureteroscopy Procedures: A Single-Center Experience

Geavlete, P.; Georgescu, D.; Nita, G.; Mirciulescu, V.; Cauni, V.

doi:10.1089/end.2006.20.179

Cited by 277 publications

(178 citation statements)

References 18 publications

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“…The overall complication rate after URS was reported as 9-25% in the literature. [12,13] Hong et al [14] reported that use of smallcalibre equipment reduced complications and morbidity related to URS significantly. A study that compared different-calibre URS reported the complication rates of small-calibre URS as 1.2-13.1%.…”

Section: Discussionmentioning

confidence: 99%

The effect of ureteroscope size in the treatment of ureteral stone: 15-year experience of an endoscopist

Kılınç¹,

Doluoğlu²,

Karakan³

et al. 2016

Turkish Journal of Urology

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Section: Discussionmentioning

confidence: 99%

The effect of ureteroscope size in the treatment of ureteral stone: 15-year experience of an endoscopist

Kılınç¹,

Doluoğlu²,

Karakan³

et al. 2016

Turkish Journal of Urology

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“…[23] In our study, the overall complication rate was 6.1% and 2.2% for Group 1 and Group 2, respectively (p=0.3). The urosepsis observed in 2 patients in Group 2 was managed with parenteral antibiotics and supportive measures.…”

Section: Discussionmentioning

confidence: 42%

Previous shock-wave lithotripsy treatment does not impact the outcomes of flexible ureterorenoscopy

Yürük¹,

Binbay²,

Akman³

et al. 2014

Turkish Journal of Urology

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Objective: Shock-wave lithotripsy (SWL) is the first-line treatment for the active removal of small and medium-sized kidney stones. Flexible ureterorenoscopy (fURS) is recommended after failed SWL treatment. The aim of this retrospective analysis is to evaluate whether prior unsuccessful SWL treatments affect the outcomes of fURS. Material and methods:Data from 206 patients who underwent fURS for the treatment of renal stones between September 2009 and January 2011 were collected, and the patients were divided into two groups according to their previous SWL treatment. The patient demographics, stone characteristics, operation and fluoroscopy times, stone-free rates and complications were compared.Results: Of the patients, 114 (55.3%) did not undergo SWL prior to fURS (Group 1), whereas 92 (44.6%) completed a minimum of 3 sessions of SWL and waited at least 2 weeks before the fURS operation (Group 2). Although the mean stone number was higher in Group 2, this difference was not significant (p= 0.06). The mean operation (p= 0.12) and fluoroscopy times (p= 0.69) were similar between the groups. The mean operation time per mm 2 stone and fluoroscopy time per mm2 stone were not significantly different (p= 0.64 and p= 0.76, respectively). The length of the hospitalization and the overall complication rates were similar. After the third postoperative month, the stone-free rates were not different between the groups (82.5% and 86.9%, respectively, p=0.38). Conclusion:The stone-free and complication rates of fURS were not affected by previous SWL therapy.

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“…[3][4][5]7,9,14,15 Complication rates during ureteroscopy correlate with prolonged operative duration, as well as surgeon experience. 3 The treatment of impacted ureteral calculi are also associated with a greater rate of complications, as well as unsuccessful interventions.…”

Section: Discussionmentioning

confidence: 99%

“…6 Factors associated with higher complication rates during ureteroscopy are longer surgery times, treatment of renal calculi, surgeon inexperience, and previous irradiation. 1,3,7 Ureteral stents are the cornerstone in the management of ureteral injury. If stent placement is not possible following ureteral injury, placement of a percutaneous nephrostomy tube is required for renal drainage until elective repair can be accomplished.…”

mentioning

confidence: 99%

Simultaneous percutaneous nephrolithotomy and early endoscopic ureteric realignment for iatrogenic ureteropelvic junction avulsion during ureteroscopy

Tayeb

Mellon

Lingeman

2015

CUAJ

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E882Cite as: Can Urol Assoc J 2015;9(11-12):E882-5 http://dx.doi.org/10.5489/cuaj.2830 Published online December 14, 2015. AbstractWe present a case report of successful management of ureteropelvice junction avulsion during ureteroscopy successfully managed with simultaneous percutaneous nephrolithotomy and early endoscopic ureteral realignment. IntroductionThe incidence of ureteral injury and overall complications during ureteroscopy ranges from 0 to 28%. [1][2][3][4][5] Iatrogenic ureteral injury varies from minor mucosal petechiae to erosion, perforation, and rarely complete ureteral avulsion. 6 Factors associated with higher complication rates during ureteroscopy are longer surgery times, treatment of renal calculi, surgeon inexperience, and previous irradiation. 1,3,7 Ureteral stents are the cornerstone in the management of ureteral injury. If stent placement is not possible following ureteral injury, placement of a percutaneous nephrostomy tube is required for renal drainage until elective repair can be accomplished. 1,[8][9][10] Several authors have reported reasonable rates of success with ureteroscopic ureteral realignment for iatrogenic ureteral injury during gynecologic and general surgical procedures.9-13 However, to our knowledge, there has not been a previous report of successful endoscopic ureteral realignment following avulsion of the ureter at the level of the ureteropelvic junction. Case reportA 59-year-old female with a long history of nephrolithiasis had a 7-mm right renal pelvic calculus. Ureteroscopic treatment was performed at an outside institution. There was some difficulty with ureteral dilatation and UPJ avulsion of the ureter was suspected associated with insertion of the ureteral access sheath. A safety guide wire was not used during the procedure. Subsequently, a guide wire was not able to be passed beyond the injury into the renal collecting system and, therefore, a stent could not be placed. A 5F ureteral catheter was placed through the avulsed proximal ureter projecting into the retroperitoneum. The patient was transferred to Indiana University Health Methodist Hospital for subsequent management.The patient has a history of cirrhosis, splenomegaly, and thrombocytopenia with a platelet count of 52,000 and an INR of 1.5. Ureteroscopy was performed confirming complete avulsion of the ureter (Fig. 1). A stent could not be placed and a ureteral catheter was replaced into the retroperitoneum near the kidney. The following day a percutaneous nephrostomy was inserted by Interventional Radiology (Fig. 2). The patient was then returned to the operating room and placed in a prone split-leg position to allow for simultaneous antegrade and retrograde access to the ureter. The percutaneous access was dilated to 30F and an Amplatz sheath was positioned into the kidney (Fig. 3). Nephroscopy identified the stone in the renal pelvis which was removed. The UPJ was identified and noted to be very small in caliber. A flexible ureteroscope was passed antegradely through the UPJ confirming that the avu...

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Complications of 2735 Retrograde Semirigid Ureteroscopy Procedures: A Single-Center Experience

Abstract: According to our experience, mastery of ureteroscopic technique allows the urologist to proceed endourologically with minimum morbidity. Despite the new smaller semirigid instruments, this minimally invasive maneuver may sometimes be aggressive, and adequate training is imperative.

Cited by 277 publications

References 18 publications

The effect of ureteroscope size in the treatment of ureteral stone: 15-year experience of an endoscopist

The effect of ureteroscope size in the treatment of ureteral stone: 15-year experience of an endoscopist

Previous shock-wave lithotripsy treatment does not impact the outcomes of flexible ureterorenoscopy

Simultaneous percutaneous nephrolithotomy and early endoscopic ureteric realignment for iatrogenic ureteropelvic junction avulsion during ureteroscopy

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