Literature DB >> 36208314

Randomized comparison of 4.5/6 Fr versus 6/7.5 Fr ureteroscopes for laser lithotripsy of lower/middle ureteral calculi: towards optimization of efficacy and safety of semirigid ureteroscopy.

Mohamed Omar1, Mohammed Dorrah2, Ahmed Khalifa2, Eid El Sherif2, Khalid Sayedahmed2,3, Yahya Ghazwani4, Yasser A Noureldin4,5.   

Abstract

BACKGROUND AND
PURPOSE: To compare 4.5/6 Fr versus 6/7.5 Fr semirigid ureteroscopes in terms of safety and efficacy in adult non-obese patients with middle or lower ureteric stones.
MATERIALS AND METHODS: A total of 198 patients with middle/lower ureteric stone and a BMI ≤ 30 kg/m2 were recruited. Patients were randomized according to the size of ureteroscope into two groups: group 1 where a 4.5/6 Fr semi-rigid ureteroscope was used, and group 2 where a 6/7.5 Fr semi-rigid ureteroscope was used. Patient's demographic, stone characteristics, intraoperative and postoperative outcomes including stone-free rate (SFR) and complications were compared.
RESULTS: Preoperative characteristics in terms of age, sex, BMI, and stone location, side, size, and HU were comparable between both groups (p values > 0.05). The overall SFR was significantly higher in group 1 (0.004). Balloon dilatation was not required in all patients of group-1 compared with 33% of group-2 (p = 0.0001). The JJ stent was required in 10% of group-1 compared with 30% of group-2 (p = 0.0004). Failure to reach the stone due to tight ureter occurred in 8% of group 2 (p = 0.003), respectively. Traxer's grade 1 ureteral injury occurred in 2% of group-1 versus 14% of group-2 (p = 0.001). Consequently, hematuria was significantly lower in group-1 (1% vs. 8%; p = 0.01), respectively. The hospital stay < 9 h was significantly higher in group 1 (p = 0.0001).
CONCLUSIONS: The 4.5/6 Fr semi-rigid Ureteroscope was associated with significantly higher SFR and shorter hospital stay, with lower ureteral injury, fewer double-J stenting, and without the need for intraoperative balloon dilatation for the ureter.
© 2022. The Author(s).

Entities:  

Keywords:  Calculi; Efficacy; Optimization; Safety; Ureteroscopy

Year:  2022        PMID: 36208314     DOI: 10.1007/s00345-022-04173-2

Source DB:  PubMed          Journal:  World J Urol        ISSN: 0724-4983            Impact factor:   3.661


  13 in total

1.  Observation of ureteric diameter in negative intravenous urogram in hospital universiti kebangsaan malaysia.

Authors:  Siong Lung Wong; Hamzaini Abdul Hamid
Journal:  Malays J Med Sci       Date:  2010-04

2.  Complications of Flexible Ureteroscopic Treatment for Renal and Ureteral Calculi during the Learning Curve.

Authors:  Masatsugu Komori; Hirofumi Izaki; Kei Daizumoto; Megumi Tsuda; Yoshito Kusuhara; Hidehisa Mori; Junichiro Kagawa; Kunihisa Yamaguchi; Yasuyo Yamamoto; Tomoharu Fukumori; Masayuki Takahashi; Hiro-Omi Kanayama; Manabu Sakaki; Hiroyoshi Nakatsuji; Takumi Hamao; Hiroyasu Miura
Journal:  Urol Int       Date:  2015-03-27       Impact factor: 2.089

3.  [Transurethral ureterolithotripsy with rigid ureteroscope--efficacy of balloon dilation of ureteral orifice and intramural ureter].

Authors:  N Katoh; T Sugiyama; M Itoh; Y Ono; S Yamada; O Kamihira; S Ohshima
Journal:  Nihon Hinyokika Gakkai Zasshi       Date:  1993-09

Review 4.  Ureteroscopic stone retrieval: rigid versus flexible endoscopes.

Authors:  D H Bagley
Journal:  Semin Urol       Date:  1994-02

5.  Surgical Management of Stones: American Urological Association/Endourological Society Guideline, PART I.

Authors:  Dean Assimos; Amy Krambeck; Nicole L Miller; Manoj Monga; M Hassan Murad; Caleb P Nelson; Kenneth T Pace; Vernon M Pais; Margaret S Pearle; Glenn M Preminger; Hassan Razvi; Ojas Shah; Brian R Matlaga
Journal:  J Urol       Date:  2016-05-27       Impact factor: 7.450

6.  Prospective evaluation and classification of ureteral wall injuries resulting from insertion of a ureteral access sheath during retrograde intrarenal surgery.

Authors:  Olivier Traxer; Alexandre Thomas
Journal:  J Urol       Date:  2012-10-08       Impact factor: 7.450

7.  Ureteroscopic management of lower ureteric calculi: a 15-year single-centre experience.

Authors:  Osama M Elashry; Abdelnaser K Elgamasy; Magdy A Sabaa; Mohamed Abo-Elenien; Mohamed Adel Omar; Hassan H Eltatawy; Shawky A El-Abd
Journal:  BJU Int       Date:  2008-05-15       Impact factor: 5.588

8.  Impact of obesity on ureteroscopic laser lithotripsy of urinary tract calculi.

Authors:  Ricardo Natalin; Keith Xavier; Zephaniah Okeke; Mantu Gupta
Journal:  Int Braz J Urol       Date:  2009 Jan-Feb       Impact factor: 1.541

9.  Configuring a Better Estimation of Kidney Size in Obese Children and Adolescents.

Authors:  Fahimeh Soheilipour; Fatemeh Jesmi; Nahid Rahimzadeh; Mohadeseh Pishgahroudsari; Fariba Almassinokian; Ali Mazaherinezhad
Journal:  Iran J Pediatr       Date:  2016-03-05       Impact factor: 0.364

10.  The Efficacy of Ultra-thin Semi-rigid Ureteroscopy with Holmium Laser Lithotripsy in Pediatric Ureteral Stones: A Single-center Experience.

Authors:  Ramazan Topaktas; Cemil Aydin; Selcuk Altin; Ali Akkoc; Zeynep B Aydın; Ahmet Urkmez
Journal:  Cureus       Date:  2019-08-27
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