European Association of Urology Section of Urolithiasis and International Alliance of Urolithiasis Joint Consensus on Retrograde Intrarenal Surgery for the Management of Renal Stones

Zeng, Guohua; Zhao, Zhijian; Mazzon, Giorgio; Pearle, Margaret S.; Choong, Simon; Skolarikos, Andreas; Denstedt, John D.; Seitz, Christian; Pasada, Daniel Olvera; Fiori, Cristian; Bosio, Adrea; Papatsoris, Athanasios; Probst, Carlos Enrique Méndez; Fentes, Daniel Perez; Ann, Kah; Wu, Qinghui; Wiseman, Oliver; Emiliani, Esteban; Farahat, Yasser; Gökçe, Mehmet İlker; Giannakopoulos, Stilianos; Kartalas, Ioannis Goumas; Somani, Bhaskar; Knoll, Thomas; Rosette, Jean de la; Zhong, Jinglin; Maroccolo, Marcus Vinícius Osorio; Saltirov, lliya; Chew, Ben H.; Wang, Kunjie; Lahme, Sven; Giusti, Guido; Ferretti, Stefania; Cho, Sung Yong; Geavlete, P.; Cansino, Ramón; Kamphuis, Guido; Smith, Daron; Matlaga, Brian R.; Ghani, Khurshid D.; Bernardo, Norberto O.; Silva, Andres D.; Ng, Anthony; Yang, Sixing; Gao, Xin; Traxer, Olivier; Miernik, Arkadiusz; Liatsikos, Evangelos; Parikh, Kandarp Priyakant; Duvdevani, Mordechai; Celia, Antonio; Yasui, Takahiro; Aquino, Albert; Alomar, Mohammad; Choonhaklai, Vorapot; Erkurt, Bülent; Glass, Jonathan; Sriprasad, Seshadri; Osther, Palle Jørn Sloth; Keeley, Francis X.; Preminger, Glenn M.; Delgado, Manuel; Suárez, Edgar Beltrán; Ye, Zhangqun; Sarıca, Kemal

doi:10.1016/j.euf.2021.10.011

Cited by 40 publications

(30 citation statements)

References 36 publications

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“…F-URS is increasingly favored by physicians and patients as it has advantage of being minimally invasive and can reach the surgical site through the body's natural channels, making it less damaging to the kidneys and blood vessels ( 13 , 14 ). The EAU and AUA guidelines state that f-URS can achieve a similar SFR to PNL for kidney stones 1–2 cm in length with lower complications.…”

Section: Discussionmentioning

confidence: 99%

Comparison of flexible ureteroscopy in the treatment of 1–2 cm single nephrolithiasis and multiple nephrolithiasis

Zhou

et al. 2023

Front. Surg.

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ObjectiveTo compare the efficacy of flexible ureteroscopy for single urinary stones with that of multiple urinary stones.MethodsA retrospective study was conducted on patients who underwent flexible ureteroscopy in Qilu Hospital of Shandong University from January 2016 to March 2021. Propensity score matching was used to match patients with no statistical difference in preoperative clinical data, and they were divided into solitary calculi and multiple calculi two groups. The postoperative hospital days, operation time, complications and stone free rate were compared between the two groups. And multiple stones were divided into high group (S-ReSc > 4) and non-high group (S-ReSc ≤ 4) for analysis.Results313 patients were counted. After propensity score matching, 198 patients were finally included in the study. There were 99 cases in the solitary stone group and the multiple stone group. There were no significant differences in postoperative hospital days, complications and stone free rate between the two groups. The operation time of patients with solitary stone group was significantly shorter than that of patients with multiple stones (65.00 min, 45.00 min VS 90.00 min, 50.00 min, P < 0.001). The SFR of high group in the multiple stones group was significantly lower than that in the non-high group (7, 58.3% VS 78, 89.7%, P = 0.013).ConclusionDespite the longer operation time, flexible ureteroscopy has similar outcomes in the treatment of multiple (S-Rec ≤ 4) compared to solitary calculi. Although, this doesn't apply when S-ReSc > 4.

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Section: Discussionmentioning

confidence: 99%

Comparison of flexible ureteroscopy in the treatment of 1–2 cm single nephrolithiasis and multiple nephrolithiasis

Zhou

et al. 2023

Front. Surg.

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“…Many studies have suggested that indwelling double-J stents result in higher success rates for UAS placement as ureteral stenting increases the luminal circumference of ureters [1,4,5,14]. Patients who received preoperative ureteral stenting were not included in this study because EAU guidelines did not suggest routine placement of ureteral stents before RIRS [4,6]. Alkhamees and others performed a study to identify the failure rate of insertion of a 10/12-Fr UAS, the outcomes were similar to our study, and in that, no statistically significant difference was found in age, BMI, and stone burden between the success and failure groups [13].…”

Section: Discussionmentioning

confidence: 99%

“…In vitro experiments showed that one week of ureteral stenting resulted in nearly a 4Fr increase in the luminal circumference of porcine ureters [5]. Nevertheless, European Association of Urology (EAU) guidelines did not suggest the routine placement of ureteral stents before RIRS [4,6]; it is of significant importance to identify risk factors for the failure of ureteral access sheath placement. e size of the UAS has impacted the success of UAS insertion, smaller diameter UASs (<12/14 Fr) decrease the risk of ureteral wall injury, and larger diameter UASs (>12/ 14 Fr) are observed to improve surgical efficiency at the cost of greater risks of placement failures [7].…”

Section: Introductionmentioning

confidence: 99%

Identification of the Risk Factors for the Failure of Ureteral Access Sheath Placement

Liu

et al. 2022

International Journal of Clinical Practice

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Purpose. Insertion of a ureteral access sheath (UAS) may fail in some patients in retrograde intrarenal surgery (RIRS), and this study aimed to seek preoperative risk factors for the failure of 12/14F UAS placement. Methods. We retrospectively analyzed 260 consecutive patients who underwent RIRS between May 2020 and March 2022 at our institution. Data on patient and stone characteristics and several computed tomography (CT)-based measurements were collected and compared between the success and failure UAS placement groups. Results. Twenty-nine (11.2%) patients failed to insert the UAS. Age, gender, height, weight, stone side, stone location, length of history, and computed tomography (CT)-based parameters were not significant differences between the two groups. Univariate logistic regression analyses showed sex (female/male) (odds ratio: 0.287 and 95% CI [0.107, 0.722], p = 0.013 ), length of history 15–31 days (odds ratio: 0.315 and 95% CI [0.102, 0.974], p = 0.045 ), length of history >31 days (odds ratio: 0.202 and 95% CI [0.051, 0.805], p = 0.023 ), and diameter of the ipsilateral common iliac artery (odds ratio: 1.285 and 95% CI [1.018, 1.623], p = 0.035 ) were associated with UAS placement. Conclusion. Our study indicated that males, the short length of history, and the short diameter of the ipsilateral common iliac artery were the risk factors for the failure of UAS placement.

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“…Finally, consensus was set at a threshold of minimum 80% high agreement. This is higher than in most modified Delphi consensus projects, where thresholds are usually set at 50-70% [13,14]. As our absolute priority was to make a tool that would actually be used, we deemed it necessary to set a high threshold.…”

Section: Strengths and Limitationsmentioning

confidence: 96%

The Uniform grading tooL for flexIble ureterorenoscoPes (TULIP‐tool): a Delphi consensus project on standardised evaluation of flexible ureterorenoscopes

et al. 2022

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Objective To develop a standardised tool to evaluate flexible ureterorenoscopes (fURS). Materials and Methods A three‐stage consensus building approach based on the modified Delphi technique was performed under guidance of a steering group. First, scope‐ and user‐related parameters used to evaluate fURS were identified through a systematic scoping review. Then, the main categories and subcategories were defined, and the expert panel was selected. Finally, a two‐step modified Delphi consensus project was conducted to firstly obtain consensus on the relevance and exact definition of each (sub)category necessary to evaluate fURS, and secondly on the evaluation method (setting, used tools and unit of outcome) of those (sub)categories. Consensus was reached at a predefined threshold of 80% high agreement. Results The panel consisted of 30 experts in the field of endourology. The first step of the modified Delphi consensus project consisted of two questionnaires with a response rate of 97% (n = 29) for both. Consensus was reached for the relevance and definition of six main categories and 12 subcategories. The second step consisted of three questionnaires (response rate of 90%, 97% and 100%, respectively). Consensus was reached on the method of measurement for all (sub)categories. Conclusion This modified Delphi consensus project reached consensus on a standardised grading tool for the evaluation of fURS – The Uniform grading tooL for flexIble ureterorenoscoPes (TULIP) tool. This is a first step in creating uniformity in this field of research to facilitate future comparison of outcomes of the functionality and handling of fURS.

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European Association of Urology Section of Urolithiasis and International Alliance of Urolithiasis Joint Consensus on Retrograde Intrarenal Surgery for the Management of Renal Stones

Cited by 40 publications

References 36 publications

Comparison of flexible ureteroscopy in the treatment of 1–2 cm single nephrolithiasis and multiple nephrolithiasis

Comparison of flexible ureteroscopy in the treatment of 1–2 cm single nephrolithiasis and multiple nephrolithiasis

Identification of the Risk Factors for the Failure of Ureteral Access Sheath Placement

The Uniform grading tooL for flexIble ureterorenoscoPes (TULIP‐tool): a Delphi consensus project on standardised evaluation of flexible ureterorenoscopes

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