Same-Session Bilateral Ureteroscopy: Safety and Outcomes

Ingimarsson, Johann P.; Rivera, Marcelino; Knoedler, John J.; Krambeck, Amy E.

doi:10.1016/j.urology.2017.06.027

Cited by 13 publications

(7 citation statements)

References 26 publications

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“…6,7,10 Previous retrospective series reported that SFR ranged from 42.0% to 92.8%. [11][12][13][14][15][16] This wide range reflects the different image modalities used to evaluate this outcome. Lack of a comparative group makes these low-quality data.…”

Section: Discussionmentioning

confidence: 99%

Prospective Evaluation of Bilateral Retrograde Intrarenal Surgery: Is It Really Safe?

Danilovic

Torricelli

Marchini

et al. 2021

Journal of Endourology

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Introduction:The aim of this study was to prospectively compare the outcomes of bilateral same-session retrograde intrarenal surgery (BSS RIRS) with unilateral RIRS and to compare the outcomes of first with second operated kidneys in BSS RIRS. Subjects and Methods: Consecutive symptomatic adult patients with kidney stones up to 20 mm who accepted to be treated by RIRS were prospectively studied. Stone-free rate (SFR) was evaluated by non-contrast CT for each renal unit, and surgical complications were evaluated based on Clavien-Dindo classification. Results: SFR (73.9% vs 76.1%, p = 0.830) and hospitalization time (14.43 -18.81 hours vs 13.00 -4.89 hours, p = 0.564) were similar between unilateral and BSS RIRS groups, with less consumption of disposable devices in BSS RIRS ( p = 0.017). Operative time was longer in BSS RIRS (61.24 -26.62 minutes vs 88.65 -33.19 minutes, p < 0.001). Bilateral group had significant more overall complications by Clavien-Dindo classification than unilateral (15.9% vs 39.9%, p = 0.030) and more emergency room (ER) visits (11.6% vs 34.8%, p = 0.026). Moreover, although both groups temporarily increased creatinine levels, it was significantly higher in bilateral RIRS ( p = 0.019). First operated kidney outcomes were similar to second operated kidney outcomes of BSS RIRS. Conclusion: Although BSS RIRS had similar SFR and consumed less disposable devices, it had a higher overall complication rate, a higher frequency of ER visits, and higher creatinine levels during follow-up than unilateral RIRS. There is no significant outcome difference between first and second operated kidneys in BSS RIRS.

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Section: Discussionmentioning

confidence: 99%

Prospective Evaluation of Bilateral Retrograde Intrarenal Surgery: Is It Really Safe?

Danilovic

Torricelli

Marchini

et al. 2021

Journal of Endourology

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“…Published complication rates from earlier cohort series of bilateral URS procedures ranged from 10% to 29% [9] , [10] , [11] , [12] , [13] , [14] , [15] . In the most recent study published on same-session URS, complication rates were reported to be 16.2% [20] .…”

Section: Discussionmentioning

confidence: 99%

“…Ingimarsson et al [20] evaluated unilateral URS procedures from their own database with a complication rate of 15.8%. No significant difference between the same-session bilateral and single-session unilateral URS was found in terms of complications ( P = 0.79).…”

Section: Discussionmentioning

confidence: 99%

Bilateral same-session flexible ureterorenoscopy for renal and/or ureteric stone disease treatment

Arda

Çakıroğlu²

2018

Arab Journal of Urology

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ObjectiveTo evaluate the effectiveness and safety of bilateral same-session flexible ureterorenoscopy (f-URS) in the treatment of bilateral renal and/or ureteric stone disease.Patients and methodsFrom October 2007 to December 2015, 62 patients who had undergone bilateral, same-session f-URS were included in the study. The procedures were performed under general anaesthesia, in lithotomy, and initiated on the side in which the patient was clinically symptomatic or on the side in which the stone was smaller. Plain abdominal radiography, intravenous urography, renal ultrasonography and/or non-contrast computed tomography scans were conducted in all patients. The success rate was defined as, patients who were stone-free or only had residual fragments of <3 mm.ResultsA total of 62 patients (43 male, 19 female), with a mean (SD) age of 39 (15.1) years, were included. The mean (SD) stone size was 23.2 (6.11) mm with a mean (SD) operative time of 58.8 (16.24) min. The stone-free rates were 90.3% and 100% after the first and second procedures, respectively. The mean (SD) hospital stay was 1.58 (0.72) days. There were minor complications (Clavien–Dindo grade I–II) in 10 (16%) patients and major complications (Clavien–Dindo III–IV), e.g. distal ureter laceration and laser injury of the ureter, in two patients.ConclusionSame session bilateral f-URS is a successful and safe method for bilateral renal and/or ureteric stones.

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“…There were 16 studies [7][8][9][10][11] of bilateral simultaneous ureteroscopy (BS-URS), including 1073 patients (660 men, 413 women) with a mean age of 46.5 years. Stone proportions were reported in size or burden by different studies and are summarised in Table 1.…”

Section: Bilateral Simultaneous Ureteroscopy (Table 1)mentioning

confidence: 99%

“…This review provides an up to date and comprehensive overview on bilateral simultaneous endourological procedures for bilateral stone disease [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. A total of 1966 patients (across 32 studies) were included.…”

Section: Meaning Of the Studymentioning

confidence: 99%

Simultaneous Bilateral Endoscopic Surgery (SBES) for Bilateral Urolithiasis: the Future? Evidence from a Systematic Review

2019

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Purpose of Review Urolithiasis is a disease of prevalence across the world and up to a quarter of patients present with multiple stones. Most procedures carried out in this scenario are staged; however, there is a growing body of evidence to suggest bilateral simultaneous (BS) procedures are safe. We performed a systematic review to investigate and evaluate the evidence for these procedures. Recent Findings A systematic review was conducted according to Cochrane and PRISMA checklist for all English-language articles from January 1996 to January 2018 using Medline, CINAHL, Scopus, EMBASE, Cochrane library, Clinicaltrials.gov and Google Scholar. All studies (a minimum of 10 patients) with bilateral simultaneous percutaneous nephrolithotomy (BS-PCNL) or bilateral simultaneous ureteroscopy (BS-URS) and ipsilateral URS with contralateral simultaneous PCNL were included. Data was extracted for patient and stone demographics, outcomes and stone-free rate (SFR) and the level of evidence (using the GRADE assessment tool). Overall, 32 studies (1966 patients) were included in the review after the identification of 302 articles in the search. This included 16 studies (1073 patients) with BS-URS, 13 studies (750 patients) with BS-PCNL and 3 studies (143 patients) with URS and simultaneous contralateral PCNL. Of these, 8 were comparative studies and compared bilateral simultaneous procedure to either a unilateral or staged comparator. The mean operating time, SFR, the Clavien I-II and the Clavien ≥ III were 75 min, 91%, 22% and 1.4% for BS-URS; 157 min, 92%, 27% and 6.4% for BS-PCNL; 151 min, 76% and 5.6% for URS with contralateral PCNL. In comparison to staged procedures, although the SFR and complication rates were similar, there was a significantly reduced operative time and hospital stay with simultaneous procedures (p < 0.001). Summary Although evidence for bilateral simultaneous endourological procedures is limited, results from available studies show that outcomes are at least equivalent to staged procedures. Key advantages seem to be reduced operative times, cost and hospital stay which will lead to an increased uptake of these procedures in the future.

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Same-Session Bilateral Ureteroscopy: Safety and Outcomes

Cited by 13 publications

References 26 publications

Prospective Evaluation of Bilateral Retrograde Intrarenal Surgery: Is It Really Safe?

Prospective Evaluation of Bilateral Retrograde Intrarenal Surgery: Is It Really Safe?

Bilateral same-session flexible ureterorenoscopy for renal and/or ureteric stone disease treatment

Simultaneous Bilateral Endoscopic Surgery (SBES) for Bilateral Urolithiasis: the Future? Evidence from a Systematic Review

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