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Outcomes of flexible ureteroscopy and laser fragmentation for treatment of large renal stones with and without the use of ureteral access sheaths: Results from a university hospital with a review of literature

Outcomes of flexible ureteroscopy and laser fragmentation for treatment of large renal stones with and without the use of ureteral access sheaths: Results from a university hospital with a review of literature
Outcomes of flexible ureteroscopy and laser fragmentation for treatment of large renal stones with and without the use of ureteral access sheaths: Results from a university hospital with a review of literature

OBJECTIVE: The aim of this study was to analyse prospective data on flexible ureteroscopy and laser fragmentation (FURSL) of large stones (> 2 cm) to assess whether a ureteral access sheath (UAS) is necessary for the treatment of large renal stones.

MATERIALS AND METHODS: Between March 2012 and October 2014, 43 patients with large stones underwent FURSL. Data were collected on a prospective database for patient demographics, stone characteristics and outcomes of FURSL with and without a UAS.

RESULTS: There were 27 men and 16 women with a mean age of 54 years (range 7-84 years). The cumulative stone diameter was 2.92 cm (range 2-5 cm), with an overall stone-free rate (SFR) of 83.7%. A total of 68 procedures was needed (average 1.58 procedures/patient). The overall complication rate was 8.8% (n = 6); these were Clavien class II complications associated with urinary tract infections treated with additional antibiotics. UAS was not used in 28 procedures (41.2%). Comparing outcomes in those who had a UAS versus those who did not, there were no statistical differences in SFR, complication rate or average number of procedures per patients.

CONCLUSION: Use of a UAS does not make any difference to the SFR or complication rate for FURSL in large stones (> 2 cm) and may not be routinely needed in all cases.

Adolescent, Adult, Aged, Aged, 80 and over, Child, Female, Hospitals, University, Humans, Kidney Calculi, Laser Therapy, Male, Middle Aged, Prospective Studies, Treatment Outcome, Ureter, Ureteroscopes, Ureteroscopy, Young Adult, Journal Article, Review
2168-1805
216-219
Geraghty, Robert M.
65977705-49f3-48b7-8a80-a86c26955755
Ishii, Hiro
d2dd0ce3-0ccd-4cb4-8aa1-f6d363e29b90
Somani, Bhaskar K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Geraghty, Robert M.
65977705-49f3-48b7-8a80-a86c26955755
Ishii, Hiro
d2dd0ce3-0ccd-4cb4-8aa1-f6d363e29b90
Somani, Bhaskar K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9

Geraghty, Robert M., Ishii, Hiro and Somani, Bhaskar K. (2016) Outcomes of flexible ureteroscopy and laser fragmentation for treatment of large renal stones with and without the use of ureteral access sheaths: Results from a university hospital with a review of literature. Scandinavian Journal of Urology, 50 (3), 216-219. (doi:10.3109/21681805.2015.1121407).

Record type: Review

Abstract

OBJECTIVE: The aim of this study was to analyse prospective data on flexible ureteroscopy and laser fragmentation (FURSL) of large stones (> 2 cm) to assess whether a ureteral access sheath (UAS) is necessary for the treatment of large renal stones.

MATERIALS AND METHODS: Between March 2012 and October 2014, 43 patients with large stones underwent FURSL. Data were collected on a prospective database for patient demographics, stone characteristics and outcomes of FURSL with and without a UAS.

RESULTS: There were 27 men and 16 women with a mean age of 54 years (range 7-84 years). The cumulative stone diameter was 2.92 cm (range 2-5 cm), with an overall stone-free rate (SFR) of 83.7%. A total of 68 procedures was needed (average 1.58 procedures/patient). The overall complication rate was 8.8% (n = 6); these were Clavien class II complications associated with urinary tract infections treated with additional antibiotics. UAS was not used in 28 procedures (41.2%). Comparing outcomes in those who had a UAS versus those who did not, there were no statistical differences in SFR, complication rate or average number of procedures per patients.

CONCLUSION: Use of a UAS does not make any difference to the SFR or complication rate for FURSL in large stones (> 2 cm) and may not be routinely needed in all cases.

Full text not available from this repository.

More information

e-pub ahead of print date: 12 January 2016
Published date: 3 May 2016
Keywords: Adolescent, Adult, Aged, Aged, 80 and over, Child, Female, Hospitals, University, Humans, Kidney Calculi, Laser Therapy, Male, Middle Aged, Prospective Studies, Treatment Outcome, Ureter, Ureteroscopes, Ureteroscopy, Young Adult, Journal Article, Review

Identifiers

Local EPrints ID: 419379
URI: https://eprints.soton.ac.uk/id/eprint/419379
ISSN: 2168-1805
PURE UUID: cc42cbf5-26b7-4cfd-8e7e-1a18dd5bd087

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Date deposited: 11 Apr 2018 16:30
Last modified: 07 Jan 2019 17:31

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