Semi-rigid ureteroscope as a dilator in renal stone ureteroscopic treatment.

Abstract

INTRODUCTION:

To determine the efficacy and safety of using the semi-rigid ureteroscope as the only ureteral dilator for primary ureteroscopy (URS) in the treatment of renal stones.

MATERIALS AND METHODS:

A retrospective review of primary URS for renal stone disease was performed on consecutive patients treated by a single provider from 2013 to 2017. Utilizing wire placement under fluoroscopic guidance and direct visual ureteroscopic dilation with a semi-rigid ureteroscope, primary outcome was successful completion of stone treatment. In addition, perioperative safety was evaluated.

RESULTS:

A total of 126 consecutive cases of primary URS using the semi-rigid ureteroscope as the only ureteral dilator were attempted for renal stone treatment. The renal stones were treated in 124 (98.4%) patients without other forms of active ureteral dilation. Two (1.6%) patients required ureteral stent placement for passive dilation despite attempted other dilating techniques. No intraoperative ureteral perforations were identified. Postoperative radiographic follow up was available for 67% patients with a 91% stone free rate and no hydronephrosis or ureteral strictures were detected.

CONCLUSION:

Utilizing direct visual semi-rigid ureteroscopic dilation with a semi-ridged ureteroscope prior to flexible ureteroscopy leads to successful primary ureteroscopy for renal stone treatment in most patients. This technique is an effective, safe and possibly cost-effective method of obtaining ureteral access to facilitate primary URS for renal stone treatment.

• Authors: Amy M Reed, Eric C Umbreit, James K Aden, Christopher L Allam
• Journal: The Canadian journal of urology (Can J Urol) Vol. 27 Issue 4 Pg. 10317-10321 (08 2020) ISSN: 1195-9479 [Print] Canada
• PMID: 32861259 (Publication Type: Journal Article)

Topics

• Adult
• Dilatation (instrumentation)
• Equipment Design
• Female
• Humans
• Kidney Calculi (surgery)
• Male
• Middle Aged
• Retrospective Studies
• Treatment Outcome
• Ureteroscopes (adverse effects)
• Ureteroscopy