The University of Southampton
University of Southampton Institutional Repository

Results of day-case ureterorenoscopy (DC-URS) for stone disease: prospective outcomes over 4.5 years

Results of day-case ureterorenoscopy (DC-URS) for stone disease: prospective outcomes over 4.5 years
Results of day-case ureterorenoscopy (DC-URS) for stone disease: prospective outcomes over 4.5 years

PURPOSE: To investigate the prospective outcomes of day-case ureterorenoscopy (DC-URS) for stone disease. With the rising prevalence of stone disease in the face of finite resources, there is increasing pressure to undertake procedures as a day case avoiding in-patient stay. There are a limited number of studies reporting on the feasibility of ureteroscopy as a day-case procedure. This study aimed to investigate the prospective outcomes and predictors precluding to DC-URS for stone disease in patients treated in our university teaching hospital.

MATERIALS AND METHODS: Between March 2012 and July 2016, consecutive cases of adult stone ureteroscopy performed or supervised by a single surgeon were recorded in a prospective database. Patients underwent pre-operative counselling in a specialist stone clinic and were admitted to a dedicated 'Surgical day unit' on the day of surgery. A standardised anaesthetic protocol was adhered to in all cases. Data on patient demographics, stone parameters, pre-operative assessment, operative details, length of stay, stone-free rate and complication rates were collected and analysed.

RESULTS: A total of 544 consecutive adult ureteroscopy for stone disease were conducted over the study period with a day-case rate of 77.7%. Thirty-nine percent of failed day-case ureteroscopy were due to late completion of ureteroscopy and due to associated social circumstances of patients. The mean stone size, operating time duration and post-operative stent insertion rates for DC-URS patients were 14 mm, 46 min and 96.5%, respectively. Post-operatively, the mean stone-free rate (SFR), unplanned re-admissions and complications for DC-URS patients were 95, 4 and 4%, respectively. A higher failure of DC-URS was related to patient's age (p = 0.003), positive pre-operative urine culture (p < 0.001), elevated pre-operative serum creatinine (p < 0.001) and higher mean operating time (p < 0.02).

CONCLUSION: Based on our results, a day-case ureteroscopy rate of nearly 78% can be achieved. With its acceptable complication rate, and low re-admission rates, DC-URS is a safe and feasible option in a majority of patients with stone disease.

Journal Article
0724-4983
1757-1764
Ghosh, Anngona
3c5a161a-32d1-4285-b740-5db138f9610d
Oliver, Rachel
82bdb18f-52f3-4fef-9968-c8d58acaca76
Way, Carolyn
2083acd3-eafe-4952-9c17-1f16c2ee25e7
White, Lucy
894d1733-4abc-4d0e-9c60-a6e6088f8829
Somani, Bhaskar K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Ghosh, Anngona
3c5a161a-32d1-4285-b740-5db138f9610d
Oliver, Rachel
82bdb18f-52f3-4fef-9968-c8d58acaca76
Way, Carolyn
2083acd3-eafe-4952-9c17-1f16c2ee25e7
White, Lucy
894d1733-4abc-4d0e-9c60-a6e6088f8829
Somani, Bhaskar K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9

Ghosh, Anngona, Oliver, Rachel, Way, Carolyn, White, Lucy and Somani, Bhaskar K. (2017) Results of day-case ureterorenoscopy (DC-URS) for stone disease: prospective outcomes over 4.5 years. World Journal of Urology, 35 (11), 1757-1764. (doi:10.1007/s00345-017-2061-1).

Record type: Article

Abstract

PURPOSE: To investigate the prospective outcomes of day-case ureterorenoscopy (DC-URS) for stone disease. With the rising prevalence of stone disease in the face of finite resources, there is increasing pressure to undertake procedures as a day case avoiding in-patient stay. There are a limited number of studies reporting on the feasibility of ureteroscopy as a day-case procedure. This study aimed to investigate the prospective outcomes and predictors precluding to DC-URS for stone disease in patients treated in our university teaching hospital.

MATERIALS AND METHODS: Between March 2012 and July 2016, consecutive cases of adult stone ureteroscopy performed or supervised by a single surgeon were recorded in a prospective database. Patients underwent pre-operative counselling in a specialist stone clinic and were admitted to a dedicated 'Surgical day unit' on the day of surgery. A standardised anaesthetic protocol was adhered to in all cases. Data on patient demographics, stone parameters, pre-operative assessment, operative details, length of stay, stone-free rate and complication rates were collected and analysed.

RESULTS: A total of 544 consecutive adult ureteroscopy for stone disease were conducted over the study period with a day-case rate of 77.7%. Thirty-nine percent of failed day-case ureteroscopy were due to late completion of ureteroscopy and due to associated social circumstances of patients. The mean stone size, operating time duration and post-operative stent insertion rates for DC-URS patients were 14 mm, 46 min and 96.5%, respectively. Post-operatively, the mean stone-free rate (SFR), unplanned re-admissions and complications for DC-URS patients were 95, 4 and 4%, respectively. A higher failure of DC-URS was related to patient's age (p = 0.003), positive pre-operative urine culture (p < 0.001), elevated pre-operative serum creatinine (p < 0.001) and higher mean operating time (p < 0.02).

CONCLUSION: Based on our results, a day-case ureteroscopy rate of nearly 78% can be achieved. With its acceptable complication rate, and low re-admission rates, DC-URS is a safe and feasible option in a majority of patients with stone disease.

Text
10.1007_s00345-017-2061-1_upload - Version of Record
Download (413kB)

More information

Accepted/In Press date: 8 June 2017
e-pub ahead of print date: 15 June 2017
Published date: 1 November 2017
Keywords: Journal Article

Identifiers

Local EPrints ID: 418990
URI: http://eprints.soton.ac.uk/id/eprint/418990
ISSN: 0724-4983
PURE UUID: 8196cea4-49af-4941-a552-2f913f76f922

Catalogue record

Date deposited: 27 Mar 2018 16:30
Last modified: 06 Oct 2020 16:46

Export record

Altmetrics

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×