B Fall1, P Mouracade2, S Bergerat1, C Saussine1. 1. Service d'urologie, nouvel hôpital civil, 1, porte de l'Hôpital, 67091 Strasbourg, France. 2. Service d'urologie, nouvel hôpital civil, 1, porte de l'Hôpital, 67091 Strasbourg, France. Electronic address: pmouracade@hotmail.com.
Abstract
PURPOSE: To report our experience with Flexible Ureteroscopy-laser (FU-L) in the treatment of renal and/or ureteric stones. PATIENTS AND METHODS: We conducted a retrospective study of 191 kidney and/or ureteric stones treated in the urology department of New Civil Hospital (Strasbourg) over a period of 2 years. Two hundred and nineteen FU-L were performed. We were interested in the indications of FU-L, its complications, treatment outcomes and predictors of obtaining a stone-free outcome. Postoperative complications were reported according to the Clavien-Dindo classification. RESULTS: The indications were first line in 62.3% of cases, failures of shock wave lithotripsy in 26.2% of cases and failure of alkalinization of urine in 5.2% of cases. As intraoperative complications, we had one case of ureteropelvic avulsion and one case of bronchospasm leading to stop ureteroscopy. Postoperative complications occurred after 38 FU-L (17.3%). All grades combined these postoperative complications were infectious in 50% of cases. They were grade I, II, III, IV and V respectively in 5.9; 7.3; 2.7; 1.3 et 0% of cases. Their occurrence was not significantly correlated to the size of the stones or the unilateral or bilateral nature of the FU-L. The overall rate of stone-free was 71.7%. The factors determining significantly a stone-free outcome were the size of kidney stone and experience of the operator. CONCLUSION: In our center, the FU-L is increasingly used as first-line option due to its low morbidity and excellent results especially for the treatment of kidney stones less than 20mm and ureteric stones. It is a quality alternative to PCNL in kidney stones over 20mm.
PURPOSE: To report our experience with Flexible Ureteroscopy-laser (FU-L) in the treatment of renal and/or ureteric stones. PATIENTS AND METHODS: We conducted a retrospective study of 191 kidney and/or ureteric stones treated in the urology department of New Civil Hospital (Strasbourg) over a period of 2 years. Two hundred and nineteen FU-L were performed. We were interested in the indications of FU-L, its complications, treatment outcomes and predictors of obtaining a stone-free outcome. Postoperative complications were reported according to the Clavien-Dindo classification. RESULTS: The indications were first line in 62.3% of cases, failures of shock wave lithotripsy in 26.2% of cases and failure of alkalinization of urine in 5.2% of cases. As intraoperative complications, we had one case of ureteropelvic avulsion and one case of bronchospasm leading to stop ureteroscopy. Postoperative complications occurred after 38 FU-L (17.3%). All grades combined these postoperative complications were infectious in 50% of cases. They were grade I, II, III, IV and V respectively in 5.9; 7.3; 2.7; 1.3 et 0% of cases. Their occurrence was not significantly correlated to the size of the stones or the unilateral or bilateral nature of the FU-L. The overall rate of stone-free was 71.7%. The factors determining significantly a stone-free outcome were the size of kidney stone and experience of the operator. CONCLUSION: In our center, the FU-L is increasingly used as first-line option due to its low morbidity and excellent results especially for the treatment of kidney stones less than 20mm and ureteric stones. It is a quality alternative to PCNL in kidney stones over 20mm.
Authors: Luca Cindolo; Pietro Castellan; Cesare Marco Scoffone; Cecilia Maria Cracco; Antonio Celia; Andrea Paccaduscio; Luigi Schips; Silvia Proietti; Alberto Breda; Guido Giusti Journal: World J Urol Date: 2015-07-26 Impact factor: 4.226