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Feasibility and safety of bilateral same-session flexible ureteroscopy (FURS) for renal and ureteral stone disease

Feasibility and safety of bilateral same-session flexible ureteroscopy (FURS) for renal and ureteral stone disease
Feasibility and safety of bilateral same-session flexible ureteroscopy (FURS) for renal and ureteral stone disease

INTRODUCTION: With rising incidence of urolithiasis, treatment of stones (both symptomatic and asymptomatic) in multiple locations including bilateral stones can be controversial and challenging. We report our experience and treatment outcomes in patients undergoing bilateral, same-session ureterorenoscopy (BS-URS) for bilateral ureteric and/or renal calculi, and discuss the advantages and disadvantages of such procedures.

MATERIAL AND METHODS: Between May 2012 and October 2013, 251 patients underwent ureteroscopic surgery for stone disease at our institution. Of these, 21 patients underwent 25 bilateral same-session ureterorenoscopy (BS-URS) procedures during this period. Stone-free status was defined as endoscopically stone-free or radiological fragments <2 mm.

RESULTS: The mean bilateral stone size was 21mm (range: 4-63 mm) with a mean operating time of 70 minutes (range 35-129 minutes). Fifteen procedures (60%) were done as day case procedures with a mean stay of 0.9 days (range 0-7 days). Of the 42 renal units treated, 80% (34/42) were stone-free after a single bilateral ureteroscopy session. A further 12% (5/42) were cleared after a re-look procedure making the overall stone free rate 92.8% (39/42). There were no major complications and 3 minor complications (2 early stent removals due to stent symptoms and 1 pyelonephritis requiring intravenous antibiotics).

CONCLUSIONS: Bilateral same-session ureteroscopy is a safe and effective treatment option for patients with bilateral ureteric and/or renal calculi, even with stones in multiple locations and increasing stone loads. However, as with all surgery, proper patient and equipment selection is crucial in terms of reducing complication rates and improving treatment outcomes.

Journal Article
2080-4806
193-196
Drake, Tamsin
24085add-dddd-458f-bb63-d78c01a3356a
Ali, Ahmed
71a2b47d-0a71-41a9-a090-0904a7803771
Somani, Bhaskar K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Drake, Tamsin
24085add-dddd-458f-bb63-d78c01a3356a
Ali, Ahmed
71a2b47d-0a71-41a9-a090-0904a7803771
Somani, Bhaskar K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9

Drake, Tamsin, Ali, Ahmed and Somani, Bhaskar K. (2015) Feasibility and safety of bilateral same-session flexible ureteroscopy (FURS) for renal and ureteral stone disease. Central European Journal of Urology, 68 (2), 193-196. (doi:10.5173/ceju.2015.533).

Record type: Article

Abstract

INTRODUCTION: With rising incidence of urolithiasis, treatment of stones (both symptomatic and asymptomatic) in multiple locations including bilateral stones can be controversial and challenging. We report our experience and treatment outcomes in patients undergoing bilateral, same-session ureterorenoscopy (BS-URS) for bilateral ureteric and/or renal calculi, and discuss the advantages and disadvantages of such procedures.

MATERIAL AND METHODS: Between May 2012 and October 2013, 251 patients underwent ureteroscopic surgery for stone disease at our institution. Of these, 21 patients underwent 25 bilateral same-session ureterorenoscopy (BS-URS) procedures during this period. Stone-free status was defined as endoscopically stone-free or radiological fragments <2 mm.

RESULTS: The mean bilateral stone size was 21mm (range: 4-63 mm) with a mean operating time of 70 minutes (range 35-129 minutes). Fifteen procedures (60%) were done as day case procedures with a mean stay of 0.9 days (range 0-7 days). Of the 42 renal units treated, 80% (34/42) were stone-free after a single bilateral ureteroscopy session. A further 12% (5/42) were cleared after a re-look procedure making the overall stone free rate 92.8% (39/42). There were no major complications and 3 minor complications (2 early stent removals due to stent symptoms and 1 pyelonephritis requiring intravenous antibiotics).

CONCLUSIONS: Bilateral same-session ureteroscopy is a safe and effective treatment option for patients with bilateral ureteric and/or renal calculi, even with stones in multiple locations and increasing stone loads. However, as with all surgery, proper patient and equipment selection is crucial in terms of reducing complication rates and improving treatment outcomes.

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More information

Accepted/In Press date: 2 April 2015
e-pub ahead of print date: 4 May 2015
Published date: 2015
Keywords: Journal Article

Identifiers

Local EPrints ID: 419373
URI: http://eprints.soton.ac.uk/id/eprint/419373
ISSN: 2080-4806
PURE UUID: c6ca6c37-80ae-4976-b5c7-ce676b6c39d9

Catalogue record

Date deposited: 11 Apr 2018 16:30
Last modified: 20 Mar 2020 17:31

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