Flexible, actively deflectable fiberoptic ureteronephroscopy.

We performed 76 flexible, actively deflectable ureteronephroscopic procedures in 68 patients. Of the patients 61 were examined transurethrally, 3 via an ileal loop, 2 percutaneously and 2 via ureterostomy. Indications for flexible, actively deflectable ureteronephroscopy included urolithiasis in 28 patients, upper tract filling defect in 25, lateralizing hematuria in 8, retrograde endopyelotomy in 2, post-endopyelotomy evaluation in 6, surveillance for transitional cell carcinoma in 4 and other reasons in 3. The area of interest was accessed successfully in 96% of the patients. In 57 instances an attempt was made to inspect all calices and was successful in two-thirds of the patients. However, greater than 75% of the collecting system was accessed in all but 2 of these 57 patients. Over-all, diagnostic and/or therapeutic maneuvers were successful in 84% of the patients. Flexible, actively deflectable ureteronephroscopy provides the urologist with a minimally invasive means to evaluate and treat pathological conditions of the upper urinary tract.