scholarly journals The use of flexible ureteroscopy is required to improve stone-free rates in ureteroscopy for proximal ureteral stones

2021 ◽  
pp. 001-005
Author(s):  
Bıcaklıoglu Fatih ◽  
Koparal Murat Yavuz ◽  
Bulut Ender Cem
Keyword(s):  
Flexible Ureteroscopy ◽  
Ureteral Stones

scholarly journals Impact of case volume per year on flexible Ureteroscopy practice: an internet based survey

BMC Urology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Omar Alhunaidi ◽  
Abdulrahman A. Ahmad ◽  
Ahmed R. EL-Nahas ◽  
Bader Akroof ◽  
Ali Alamiri ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Group Versus ◽  
High Volume ◽  
Internet Survey ◽  
Flexible Ureteroscopy ◽  
Ureteral Stones ◽  
Case Volume ◽  
Ureteral Access Sheath ◽  
Volume Group ◽  
Low Volume

Abstract Background To report current worldwide variation in techniques and clinical practice of flexible ureteroscopy (FURS) among endourologists of different case volumes per year. Methods Two invitations to complete an internet survey were emailed to Endourological Society members. Some of survey questions asked about indications of using FURS for renal and upper ureteral stones. Others were concerned with clinical practice of FURS (such as preoperative stenting, use of ureteral access sheath (UAS) and safety guidewire, technique of Laser lithotripsy and fragment retrieval, and post-FURS stenting. Responders were distributed into two groups; high-volume (> 100 cases/year) and low-volume surgeons (< 100 cases/year) and data were compared between both groups. Results Responses were received from 146 endourologists all over the world (62 high-volume and 84 low-volume). FURS for intrarenal stone > 20 mm was used by 61% of high-volume surgeons compared with 28.6% for low-volume (P < 0.001). Semirigid URS was used for upper ureteric stones in 68% among high-volume group and 82% in low-volume group (P = 0.044). UAS was used by 62% in low-volume group and 69% in high volume group (P = 0.516). Laser stone dusting was preferred by 63% in low-volume group versus 45% by high-volume (P = 0.031). More responders in low-volume group preferred to leave the stent for 6 weeks (P = 0.042). Conclusions The use of FURS for treating upper tract calculi has expanded by high volume endourologists to include large renal stones > 20 mm. Low-volume surgeons prefer to use semi-rigid URS for treatment of upper ureteral stones, to apply Laser stone dusting and maintain ureteral stents for longer periods.

FLEXIBLE URETEROSCOPY FOR PROXIMAL URETERAL STONES IN OBESE AND NON-OBESE PATIENTS: SINGLE SURGEON OUTCOMES

2009 ◽  
Vol 181 (4S) ◽  
pp. 451-452
Author(s):  
Sara L Best ◽  
Stephen Y. Nakada
Keyword(s):  
Flexible Ureteroscopy ◽  
Ureteral Stones ◽  
Obese Patients

scholarly journals Flexible Ureteroscopy Can Be More Efficacious in the Treatment of Proximal Ureteral Stones in Select Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Erdal Alkan ◽  
Ali Sarıbacak ◽  
Ahmet Oguz Ozkanli ◽  
Mehmet Murad Basar ◽  
Oguz Acar ◽  
...  
Keyword(s):  
Operative Time ◽  
Flexible Ureteroscopy ◽  
Ureteral Stones ◽  
Significant Difference ◽  
Ureteral Avulsion ◽  
Group 2 ◽  
Stone Characteristics ◽  
Ureteral Rupture ◽  
Treatment Procedures ◽  
Group 1

Purpose. We aimed to compare and evaluate the outcomes and complications of two endoscopic treatment procedures, semirigid ureteroscopy (SR-URS) and flexible ureteroscopy (F-URS), in the treatment of proximal ureteral stones (PUS).Methods. SR-URS (group 1) was done on 68 patients whereas 64 patients underwent F-URS (group 2) for the treatment of PUS. Success rate was defined as the absence of stone fragments or presence of asymptomatic insignificant residual fragments < 2 mm. Outcomes and complications were recorded.Results. The differences were statistically not significant in age, gender, body mass index (BMI), and stone characteristics between groups. Mean ureteral stone size was 9.1 ± 0.4 mm and 8.9 ± 0.5 mm for groups 1 and 2. Mean operative time was 34.1 ± 1.5 min and 49.4 ± 2.3 min for groups 1 and 2 (p=0.001). SFRs were 76.5% and 87.5% for groups 1 and 2 (p=0.078). Two major complications (ureteral avulsion and ureteral rupture) occurred in group 1.Conclusion. F-URS is safer and less invasive than SR-URS in patients with PUS. There is no statistically significant difference in the efficacy of either technique. Nonetheless we recommend F-URS in the management of PUS as a first-line treatment option in select cases of proximal ureteral calculi.

scholarly journals Comparison of the Efficacy of ShuoTong Ureteroscopy and Simple Flexible Ureteroscopy in the Treatment of Unilateral Upper Ureteral Calculi

2021 ◽  
Vol 8 ◽  
Author(s):  
Longhui Lai ◽  
Wenzhao Zhang ◽  
Fangjian Zheng ◽  
Tao Wang ◽  
Peide Bai ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Operative Time ◽  
Ureteral Calculi ◽  
Flexible Ureteroscopy ◽  
Ureteral Stones ◽  
Ureteral Access Sheath ◽  
Hospitalization Cost ◽  
Access Sheath ◽  
Stone Free Rate ◽  
Free Rate

Background: ShuoTong ureteroscopy (Sotn-ureteroscopy, ST-URS), a new lithotripsy operation method developed on the basis of ureteroscopy, is widely used to treat ureteral stones in China. Its composition includes rigid ureteral access sheath, standard mirror, lithotripsy mirror, and ShuoTong perfusion aspirator (ST-APM). Here, we compared the efficacy and safety of the ST-URS and the flexible ureteroscope (F-URS) holmium laser lithotripsy in the treatment of unilateral upper ureteral calculi.Methods: Retrospective analysis was conducted on the clinical data of 280 patients who met the inclusion 1) urinary tract CT was diagnosed with unilateral single upper ureteral calculi above the L4 lumbar spine; 2) patient age was from 18 to 80 years old; 3) patients were informed and consented to this study; and 4) patients were approved by the hospital ethics committee (proof number: KY-2019-020) and the exclusion criteria for unilateral upper ureteral calculi in the First Affiliated Hospital of Xiamen University from January 2018 to November 2020, and they were divided into the ST-URS group and the flexible ureteroscopy (F-URS) group.Results: The stone-free rate of 1 day after operation of the ST-URS group was significantly higher than the F-URS group (63.71 vs. 34.62%, P &lt; 0.0001). The operative time (38.45 vs. 46.18 min, P = 0.005) and hospitalization cost (27,203 vs. 33,220 Yuan, P &lt; 0.0001) of the ST-URS group were significantly lower than the F-URS group. There were no significant differences in the success rate of ureteral access sheath placement, operative blood loss, stone-free rate of 1 month after operation, postoperative complications, postoperative hospital stay, and postoperative visual analog scale (VAS) pain score between the two groups (P &gt; 0.05). In subgroups of a diameter of calculi ≥ 1.5 cm, calculi CT numerical value ≥ 1,000 Hounsfield unit and the preoperative hydronephrosis range ≥ 3.0 cm, ST-URS shows more advantages in the operative time, stone-free rate of 1 day after the operation, the hospitalization cost, and the incidence of postoperative complications.Conclusion: In unilateral upper ureteral stones treated with a holmium laser, compared with the simple F-URS, the ST-URS has a shorter operative time, lower hospitalization cost, and a higher stone-free rate of 1 day after the operation, suggesting that the ST-URS could be more widely applied in clinics.

scholarly journals Albumin-globulin ratio: a novel predictor of sepsis after flexible ureteroscopy in patients with solitary proximal ureteral stones

2020 ◽  
Vol 9 (5) ◽  
pp. 1980-1989
Author(s):  
Junlin Lu ◽  
Yang Xun ◽  
Xiao Yu ◽  
Zheng Liu ◽  
Lei Cui ◽  
...  
Keyword(s):  
Flexible Ureteroscopy ◽  
Ureteral Stones

scholarly journals Successful percutaneous flexible ureteroscopy for treatment of distal ureteral stones under modified Valdivia position after Cohen reimplantation

2019 ◽  
Vol 2 (5) ◽  
pp. 245-248 ◽  
Author(s):  
Takaaki Inoue ◽  
Fukashi Yamamichi ◽  
Takahito Endo ◽  
Yasuhiro Kaku ◽  
Mikito Horikoshi ◽  
...  
Keyword(s):  
Flexible Ureteroscopy ◽  
Ureteral Stones

Clinical experience with semirigid ureteroscopy, flexible ureteroscopy, and shock wave lithotripsy for initial treatment of 11–20-mm proximal ureteral stones

2019 ◽  
Vol 18 (7) ◽  
pp. e2755
Author(s):  
I.G. Kartal ◽  
M.Ç. Çakici ◽  
S. Sari ◽  
V. Selmi ◽  
H. Özdemir ◽  
...  
Keyword(s):  
Shock Wave ◽  
Clinical Experience ◽  
Initial Treatment ◽  
Shock Wave Lithotripsy ◽  
Flexible Ureteroscopy ◽  
Ureteral Stones

scholarly journals Comparison of semirigid ureteroscopy, flexible ureteroscopy, and shock wave lithotripsy for initial treatment of 11-20 mm proximal ureteral stones

2020 ◽  
Vol 92 (1) ◽  
pp. 39-44
Author(s):  
Ibrahim Kartal ◽  
Burhan Baylan ◽  
Mehmet Çağlar Çakıcı ◽  
Sercan Sarı ◽  
Volkan Selmi ◽  
...  
Keyword(s):  
Shock Wave ◽  
Shock Wave Lithotripsy ◽  
The Other ◽  
Flexible Ureteroscopy ◽  
Ureteral Stones ◽  
Complication Rates ◽  
Related Complication ◽  
Lower Complication ◽  
Proximal Ureter ◽  
Stone Characteristics

Objective: We aimed to retrospectively evaluate the effectiveness and safety of flexible ureteroscopy (f-URS), semirigid ureteroscopy (sr-URS), and shock wave lithotripsy (SWL) to treat single 11-20 mm stones in the proximal ureter. Materials and methods: Patients treated at our clinic for 11-20 mm single stones in the proximal ureter who underwent f-URS, sr-URS or SWL as initial lithotripsy methods were compared in terms of their clinical characteristics and treatment outcomes. Results: A comparison among 201 patients who had undergone f-URS, 119 patients who had undergone sr-URS, and 162 patients who had undergone SWL showed no significant baseline differences in patients’ demographic and stone characteristics. Stone-free rates on the 15th day and 3rd month were higher with f-URS (89.6% and 97%, respectively) than with sr-URS (67.2% and 94.1%, respectively) and SWL (41.4% and 79.0%, respectively; all p < 0.001). Retreatment rates were significantly higher with SWL than with the other two modalities (p < 0.001); auxiliary procedure rates were significantly lower with f-URS than with the other two modalities (p < 0.001). Treatment-related complication rate at the end of the 3rd month was lower with f-URS than with SWL (p = 0.022). Furthermore, f-URS was more effective than sr-URS for treating impacted stones. Conclusions: We found that f-URS was highly successful as an initial lithotripsy procedure for medium-sized proximal ureteral stones, and it helped achieve early stone-free outcomes with a lower need for retreatment and auxiliary procedures, lower complication rates, and higher effectiveness on the impacted stones compared with sr-URS and SWL.

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