The Ureteroscope as a Safety Wire for Ureteronephroscopy

Patel, Sutchin R.; McLaren, Ian D.; Nakada, Stephen Y.

doi:10.1089/end.2011.0406

Cited by 32 publications

(25 citation statements)

References 17 publications

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“…6 Two other groups reported independently their results of semi-rigid and flexible URS for the treatment of stone disease without an SGW. 5,9 Eandi et al 9 reported no intraoperative complications related to lack of a safety wire over 322 semi-rigid and flexible URS performed for the treatment of urolithiasis. Patel et al 5 described their experience with flexible URS for the treatment of calyceal and pelvic stones on 268 patients with the use of a working wire alone.…”

Section: Methodsmentioning

confidence: 99%

“…5,9 Eandi et al 9 reported no intraoperative complications related to lack of a safety wire over 322 semi-rigid and flexible URS performed for the treatment of urolithiasis. Patel et al 5 described their experience with flexible URS for the treatment of calyceal and pelvic stones on 268 patients with the use of a working wire alone. In all, 20% of the patients needed ureteral dilation, and 15% had a ureteral access sheath placed intra operatively.…”

Section: Methodsmentioning

confidence: 99%

“…Access into the renal pelvis was obtained in all patients except for one who had multiple ureteral strictures necessitating a nephrostomy tube placement with subsequent percutaneous nephrolithotomy. 5 However, the authors acknowledge that their study included only patients with kidney stones and that, for the treatment of concomitant ureteral stones associated with significant edema, ureteral strictures, abnormal anatomy or difficult visualization, a safety wire should be placed. 5 The only two available comparative studies in the literature that studied the role of an SGW for semi-rigid and flexible URS are depicted in Table 1.…”

Section: Methodsmentioning

confidence: 99%

“…5 However, the authors acknowledge that their study included only patients with kidney stones and that, for the treatment of concomitant ureteral stones associated with significant edema, ureteral strictures, abnormal anatomy or difficult visualization, a safety wire should be placed. 5 The only two available comparative studies in the literature that studied the role of an SGW for semi-rigid and flexible URS are depicted in Table 1. Moran and Bratslavsky 11 compared a single urologist's experience with flexible ureteroscopic laser lithotripsy without the use of an SGW to a contemporary, large single-center's experience with 11 treating urologists.…”

Section: Methodsmentioning

confidence: 99%

“…There is less friction passing the ureteroscope over than alongside a guidewire and increased torque to rotate the scope. 5 On the other hand, as patient safety should continue to be the highest priority, having an SGW during the entire procedure may be advised because of the risk of ureteral injury requiring prompt placement of ureteral stent. 6 The following publication aimed to look at SGW utilization during URS, reviewing the current literature available for both semi-rigid and flexible URS.…”

mentioning

confidence: 99%

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Is a safety guidewire needed for retrograde ureteroscopy?

Molina

Pessôa

Silva

et al. 2017

Rev. Assoc. Med. Bras.

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Introduction:It is generally advised to have a safety guidewire (SGW) present during ureteroscopy (URS) to manage possible complications. However, it increases the strenght needed to insert and retract the endoscope during the procedure, and, currently, there is a lack of solid data supporting the need for SGW in all procedures. We reviewed the literature about SGW utilization during URS. Method: A review of the literature was conducted through April 2017 using PubMed, Ovid, and The Cochrane Library databases to identify relevant studies. The primary outcome was to report stone-free rates, feasibility, contraindications to and complications of performing intrarenal retrograde flexible and semi-rigid URS without the use of a SGW. Results: Six studies were identified and selected for this review, and overall they included 1,886 patients where either semi-rigid or flexible URS was performed without the use of a SGW for the treatment of urinary calculi disease. Only one study reported stone-free rates with or without SGW at 77.1 and 85.9%, respectively (p=0.001). None of the studies showed increased rates of complications in the absence of SGW and one of them showed more post-endoscopic ureteral stenosis whenever SGW was routinely used. All studies recommended utilization of SGW in complicated cases, such as ureteral stones associated with significant edema, ureteral stricture, abnormal anatomy or difficult visualization. Conclusion: Our review showed a lack of relevant data supporting the use of SGW during retrograde URS. A well-designed prospective randomized trial is in order.

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