Enrique Perez Castro1, Palle J S Osther2, Viorel Jinga3, Hassan Razvi4, Konstantinos G Stravodimos5, Kandarp Parikh6, Ali R Kural7, Jean J de la Rosette8. 1. Department of Urology, Clínica La Luz, Madrid, Spain. 2. Department of Urology, Fredericia Hospital (part of Hospital Littlebelt, University of Southern Denmark), Fredericia, Denmark. 3. Department of Urology, Prof. Dr. Th. Burghele Hospital, University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania. 4. Division of Urology, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. 5. Department of Urology, Athens Medical School, Laiko Hospital, Athens, Greece. 6. Department of Urology, Shyam Urosurgical, Ahmedabad, India. 7. Department of Urology, Bilim University, Istanbul, Turkey. 8. Department of Urology, AMC University Hospital, Amsterdam, The Netherlands. Electronic address: j.j.delarosette@amc.uva.nl.
Abstract
BACKGROUND: Ureteroscopy has traditionally been the preferred approach for treatment of distal and midureteral stones, with shock wave lithotripsy used for proximal ureteral stones. OBJECTIVE: To describe the differences in the treatment and outcomes of ureteroscopic stones in different locations. DESIGN, SETTING, AND PARTICIPANTS: Prospective data were collected by the Clinical Research Office of the Endourological Society on consecutive patients treated with ureteroscopy at centres around the world over a 1-yr period. INTERVENTION: Ureteroscopy was performed according to study protocol and local clinical practice guidelines. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Stone location, treatment details, postoperative outcomes, and complications were recorded. Pearson's chi-square analysis and analysis of variance were used to compare outcomes among the different stone locations. RESULTS AND LIMITATIONS: Between January 2010 and October 2012, 9681 patients received ureteroscopy treatment for stones located in the proximal ureter (n=2656), midureter (n=1980), distal ureter (n=4479), or multiple locations (n=440); location in 126 patients was not specified. Semirigid ureteroscopy was predominantly used for all stone locations. Laser and pneumatic lithotripsy were used in the majority of cases. Stone-free rates were 94.2% for distal ureter locations, 89.4% for midureter locations, 84.5% for proximal ureter locations, and 76.6% for multiple locations. For the proximal ureter, failure and retreatment rates were significantly higher for semirigid ureteroscopy than for flexible ureteroscopy. A low incidence of intraoperative complications was reported (3.8-7.7%). Postoperative complications occurred in 2.5-4.6% of patients and varied according to location, with the highest incidence reported for multiple stone locations. Limitations include short-term follow-up and a nonuniform treatment approach. CONCLUSIONS: Ureteroscopy for ureteral stones resulted in good stone-free rates with low morbidity. PATIENT SUMMARY: This study shows that patients who have ureteral stones can be treated successfully with ureteroscopy with a low rate of complications for the patient.
BACKGROUND: Ureteroscopy has traditionally been the preferred approach for treatment of distal and midureteral stones, with shock wave lithotripsy used for proximal ureteral stones. OBJECTIVE: To describe the differences in the treatment and outcomes of ureteroscopic stones in different locations. DESIGN, SETTING, AND PARTICIPANTS: Prospective data were collected by the Clinical Research Office of the Endourological Society on consecutive patients treated with ureteroscopy at centres around the world over a 1-yr period. INTERVENTION: Ureteroscopy was performed according to study protocol and local clinical practice guidelines. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Stone location, treatment details, postoperative outcomes, and complications were recorded. Pearson's chi-square analysis and analysis of variance were used to compare outcomes among the different stone locations. RESULTS AND LIMITATIONS: Between January 2010 and October 2012, 9681 patients received ureteroscopy treatment for stones located in the proximal ureter (n=2656), midureter (n=1980), distal ureter (n=4479), or multiple locations (n=440); location in 126 patients was not specified. Semirigid ureteroscopy was predominantly used for all stone locations. Laser and pneumatic lithotripsy were used in the majority of cases. Stone-free rates were 94.2% for distal ureter locations, 89.4% for midureter locations, 84.5% for proximal ureter locations, and 76.6% for multiple locations. For the proximal ureter, failure and retreatment rates were significantly higher for semirigid ureteroscopy than for flexible ureteroscopy. A low incidence of intraoperative complications was reported (3.8-7.7%). Postoperative complications occurred in 2.5-4.6% of patients and varied according to location, with the highest incidence reported for multiple stone locations. Limitations include short-term follow-up and a nonuniform treatment approach. CONCLUSIONS: Ureteroscopy for ureteral stones resulted in good stone-free rates with low morbidity. PATIENT SUMMARY: This study shows that patients who have ureteral stones can be treated successfully with ureteroscopy with a low rate of complications for the patient.
Authors: Stavros Sfoungaristos; Ofer N Gofrit; Ioannis Katafigiotis; Dov Pode; Ezekiel H Landau; Vladimir Yutkin; Constantinos A Constantinides; Mordechai Duvdevani Journal: Int Urol Nephrol Date: 2015-10-05 Impact factor: 2.370
Authors: Jonathan Cloutier; Ken Anson; Guido Giusti; Michael Grasso; Guido Kamphuis; Sven Lahme; Evangelos Liatsikos; Anup Patel; Margaret S Pearle; Luc Valiquette; Olivier Traxer Journal: World J Urol Date: 2017-07-25 Impact factor: 4.226
Authors: Stephan Seklehner; Karl-Dietrich Sievert; Richard Lee; Paul F Engelhardt; Claus Riedl; Thomas Kunit Journal: Int Urol Nephrol Date: 2017-02-14 Impact factor: 2.370