Experience with Ureteral Stone Management in 1,082 Patients Using Semirigid Ureteroscopes

Hamano, Satoshi; Nomura, Hiroyasu; Kinsui, Hidetoshi; Oikawa, Takehiro; Suzuki, Noriyuki; Tanaka, Masashi; Murakami, Shino; Igarashi, Tatsuo; Itô, Haruo

doi:10.1159/000064849

Cited by 13 publications

(9 citation statements)

References 20 publications

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“…23,24 Most of these complications can be managed conservatively except avulsion. Mucosal injury observed in different studies range from 3.5-5%, 18,24 and mucosal injury in our study was seen in 2 (1.8%) patients. Some studies declared procedural failure or repeat procedure in range of 3-13%.…”

Section: Discussionsupporting

confidence: 48%

“…Therefore, some authors recommend using baskets or graspers to remove larger fragments produced by the pneumatic lithotripter to reduce complications and also reduce the second procedure. [17][18][19] As we also used stone forceps in most of the procedures the second procedure was not performed except in only few of our patients. However, use of stone forceps caused mucosal injury in two patients (1.8%) that was treated with DJ stenting for 3weeks.…”

Section: Discussionmentioning

confidence: 99%

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Ureteroscopic Lithotripsy; Retrospective Review of Mid and Lower Ureteric Stones- its Results and Complications

Reddy¹

2016

UNOAJ

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Purpose: To observe efficacy and complications of ureteroscopic lithotripsy in the treatment of mid and lower ureteric stones. The placement of DJ Stent was also compared for their beneficial role or otherwise. Materials and Methods: The medical records of 268 patients who underwent ureteroscopic lithotripsy (URSL) by a single surgeon from January 2010 December 2013 were reviewed retrospectively. All adult patients of mid and lower ureteric stones (10-22mm) were included in this study. Group I (n=98) patients had no DJ stent while Group II (n=96) patients had DJ stent due to prolong procedure. Group III (n=74) patients had DJ stent placed due to complications during the procedure or due to large volume of fragments that are left without retrieval after fragmentation. 28 patients required extracorporeal shockwave lithotripsy as during the procedure these patients had proximal stone migration. Results: The results were analyzed on aspects of stone clearance, hospital stay, complications and patient compliance. 80 patients in Group I, 82 patients in Group II and 42 patients in Group III completed the procedure in single session. The stone clearance at one week for mid ureteric stones in Group I (89.78%), Group II (91.67%), and Group III (91.89%) and in lower ureteric stones clearance was in Group I (97.96%), Group II (96.88%) and in Group III (95.95%). At one month 100% stone clearance was seen in all the three groups. The stented group had more complications than the non stented group. Conclusion: Ureteroscopic lithotripsy has gained wide acceptance worldwide and is an established technique for lower and mid ureteric calculi when patient demands single session removal of stone and alleviation of symptoms. Routine placement of DJ stent should be discouraged which has more complications as compared to non-stented patients.

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Section: Discussionsupporting

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Ureteroscopic Lithotripsy; Retrospective Review of Mid and Lower Ureteric Stones- its Results and Complications

Reddy¹

2016

UNOAJ

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“…However, the semirigid ureteroscope has various success and complication rates in different segments of the ureter. Some authors emphasized a lower degree of success and high complication rates in the proximal ureter [14][15][16][17] . They also reported that the proximal ureter was one of the factors which cause unfavorable results when using the semirigid ureteroscope.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Ureteral Calculi with Semirigid Ureteroscopy: Where Should We Stop?

et al. 2010

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Objectives: To evaluate the efficacy of semirigid ureteroscopy in the management of ureteral stones located in different parts of the ureter. Methods: 1,503 patients were treated with semirigid ureteroscopy. All ureteral stones were either removed only by a basket catheter or disintegrated by pneumatic lithotripsy. Success rates, auxiliary procedures, complication rates and operation time were comparatively evaluated according to stone location. Results: Overall, mean stone size and age were 12.1 ± 3.7 mm and 43.2 ± 9.72 years, respectively. While 1,416 patients (94.2%) were completely stone-free, the procedure was unsuccessful in 87 cases (5.8%). The success rate was relatively low in the proximal ureter (71.7%) when compared with the mid (94.8%) and distal ureter (98.9%) (p = 0.021). Mean operation time was 25.4 ± 11.7 min. Longer duration of operation and higher complication rate were found in proximal ureteral calculi. Stone migration to the kidney and hematuria were the main reasons of failure in the proximal ureter and ureteral stenting was needed for 56.4% of patients with upper ureteral stone. Conclusions: Semirigid ureteroscopy can be the treatment of choice in lower and midureteral stones. However, it is an invasive and less successful treatment modality for proximal ureteral stones with relatively high complication rates.

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“…The reported overall stone-free rate of semirigid URS for ureteral stones is remarkably high at 85-100% depending on stone location [2,4,5]. The initial stone free rate independent of location was 85% in our patients; this rate increased to 98% after ancillary procedures.…”

Section: Discussionmentioning

confidence: 53%

Semirigid ureteroscopy: the effect of previous ipsilateral intraureteral manipulations on stone clearance

Kurtuluş

Avcı²,

Tandoğdu

et al. 2011

Urol Res

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We investigated whether previous intraureteral manipulations had an effect on the stone-free rates (SFR) after semi-rigid ureteroscopy (URS) with pneumatic lithotripsy. A retrospective review of all patients who were treated for ureteral stones at two different institutions from June 2003 through January 2010 was performed. Data of 161 URS procedures were analyzed. Stone size, location (distal, mid and proximal) and number (single and multiple), patient demographics and previous intraureteral manipulations were recorded. Patients were grouped as having undergone a previous ipsilateral intraureteral manipulation (Group 1) or not (Group 2). Stone location and number, stone clearance and ancillary procedures were compared. There were no significant differences between Group 1 versus Group 2 for age (p > 0.05), gender (p > 0.05), stone site (p > 0.05) and stone size (p > 0.05). Stones with multiple locations were more frequent in Group 1 (18.5%); however, the difference did not reach statistical significance between the two groups. Similarly, the frequency of multiple stones was also higher in Group 1 (29.6%). Stone site, diameter and gender were comparable in both groups. Stone-free rate of all patients was 84.6% after the first intervention. This rate increased to 98.1% after secondary procedures. Univariate analysis revealed that SFR after URS were low in patients who underwent previous intraureteral manipulations (Group 1:55.6% vs. Group 2:89.1%). SFR after the first intervention were related with stone size, location and number. Additionally, multiple logistic regression analysis indicated a relationship between previous intraureteral manipulations and initial stone clearance rates. Spontaneous passage of stone fragments after URS was associated with stone burden, location, number and previous intraureteral manipulations. Further multiple logistic regression analysis showed that only previous intraureteral manipulations were associated with the expulsion of the stones left for passage.

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Experience with Ureteral Stone Management in 1,082 Patients Using Semirigid Ureteroscopes

Cited by 13 publications

References 20 publications

Ureteroscopic Lithotripsy; Retrospective Review of Mid and Lower Ureteric Stones- its Results and Complications

Ureteroscopic Lithotripsy; Retrospective Review of Mid and Lower Ureteric Stones- its Results and Complications

Treatment of Ureteral Calculi with Semirigid Ureteroscopy: Where Should We Stop?

Semirigid ureteroscopy: the effect of previous ipsilateral intraureteral manipulations on stone clearance

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