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Outcomes of ureteroscopy for stone disease in anomalous kidneys: a systematic review

Outcomes of ureteroscopy for stone disease in anomalous kidneys: a systematic review
Outcomes of ureteroscopy for stone disease in anomalous kidneys: a systematic review

Introduction: Treatment of stone disease in anomalous kidneys can be challenging. As ureteroscopy (URS) has advanced, the number of studies reporting on outcomes of URS for stone disease in anomalous kidneys has increased. Our objective was to perform a systematic review of the literature to evaluate the outcomes of URS for stone disease in this group of patients. Methods: A Cochrane style review was performed in accordance with the PRISMA guidelines using Medline, EMBASE, CINAHL, Cochrane Library, Scopus and individual urologic journals for all English language articles between inception and June 2018. Results: Fourteen papers (413 patients) with a mean age of 43 years and a male to female ratio of 285:128 were included. The underlying renal anomaly was horseshoe kidney (n = 204), ectopic kidney (n = 117), malrotation (n = 86), cross fused ectopia (n = 2) and others (n = 2). With a mean stone size of 16 mm (range 2–35 mm), the majority of stones were in the lower pole (n = 143, 34.6%) or renal pelvis (n = 128, 31.0%), with 18.9% (n = 78) having stones in multiple locations. Treatment modality included the use of flexible ureteroscope in 90% of patients and ureteral access sheath used in 11 studies. With a mean operative time of 61.3 min (range 14–185 min), the initial and final SFR was 76.6% (n = 322) and 82.3% (n = 340), respectively. The overall complication rate was 17.2% (n = 71), of which 14.8% were Clavien I/II and the remaining 2.4% were Clavien ≥ III complications. Conclusion: Although ureteroscopy in patients with anomalous kidneys can be technically challenging, advancements in endourological techniques have made it a safe and effective procedure. In these patients the stone-free rates are good with a low risk of major complications.

Ectopic kidney, Horseshoe kidney, Malrotation, Pelvic, Renal anomaly, RIRS, Ureteroscopy, Urolithiasis
0724-4983
1-12
Lavan, Lisa
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Herrmann, Thomas
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Netsch, Christopher
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Becker, Benedikt
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Somani, Bhaskar K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Lavan, Lisa
7f9bf4d3-cbb9-4df2-bee2-11293c07dfa8
Herrmann, Thomas
5ad53f66-4d90-4bbf-88b7-2b3340487909
Netsch, Christopher
fecbcd20-df7b-4ce3-823f-1be8b19920e6
Becker, Benedikt
d9f9fd58-0731-40a8-ba97-dfd8fc32f305
Somani, Bhaskar K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9

Lavan, Lisa, Herrmann, Thomas, Netsch, Christopher, Becker, Benedikt and Somani, Bhaskar K. (2019) Outcomes of ureteroscopy for stone disease in anomalous kidneys: a systematic review. World Journal of Urology, 1-12. (doi:10.1007/s00345-019-02810-x).

Record type: Review

Abstract

Introduction: Treatment of stone disease in anomalous kidneys can be challenging. As ureteroscopy (URS) has advanced, the number of studies reporting on outcomes of URS for stone disease in anomalous kidneys has increased. Our objective was to perform a systematic review of the literature to evaluate the outcomes of URS for stone disease in this group of patients. Methods: A Cochrane style review was performed in accordance with the PRISMA guidelines using Medline, EMBASE, CINAHL, Cochrane Library, Scopus and individual urologic journals for all English language articles between inception and June 2018. Results: Fourteen papers (413 patients) with a mean age of 43 years and a male to female ratio of 285:128 were included. The underlying renal anomaly was horseshoe kidney (n = 204), ectopic kidney (n = 117), malrotation (n = 86), cross fused ectopia (n = 2) and others (n = 2). With a mean stone size of 16 mm (range 2–35 mm), the majority of stones were in the lower pole (n = 143, 34.6%) or renal pelvis (n = 128, 31.0%), with 18.9% (n = 78) having stones in multiple locations. Treatment modality included the use of flexible ureteroscope in 90% of patients and ureteral access sheath used in 11 studies. With a mean operative time of 61.3 min (range 14–185 min), the initial and final SFR was 76.6% (n = 322) and 82.3% (n = 340), respectively. The overall complication rate was 17.2% (n = 71), of which 14.8% were Clavien I/II and the remaining 2.4% were Clavien ≥ III complications. Conclusion: Although ureteroscopy in patients with anomalous kidneys can be technically challenging, advancements in endourological techniques have made it a safe and effective procedure. In these patients the stone-free rates are good with a low risk of major complications.

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Lavan 2019 Article Outcomes Of Ureteroscopy For Stone - Version of Record
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Accepted/In Press date: 11 May 2019
e-pub ahead of print date: 17 May 2019
Keywords: Ectopic kidney, Horseshoe kidney, Malrotation, Pelvic, Renal anomaly, RIRS, Ureteroscopy, Urolithiasis

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Local EPrints ID: 431651
URI: http://eprints.soton.ac.uk/id/eprint/431651
ISSN: 0724-4983
PURE UUID: 4eb1562b-a9c8-4505-8a5a-aca58cb2854a

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Date deposited: 12 Jun 2019 16:30
Last modified: 07 Oct 2020 00:16

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Author: Lisa Lavan
Author: Thomas Herrmann
Author: Christopher Netsch
Author: Benedikt Becker

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