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Hamid P, Reza M, Ali K, Azar DP, Reza B. Comparison of the outcome of trans-ureteral lithotripsy for uncomplicated ureteral stones with or without safety guidewire: A randomized clinical trial. Urologia 2022:3915603221127653. [DOI: 10.1177/03915603221127653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Introduction: Using a safety wire during trans-ureteral lithotripsy (TUL) might minimize ureteral injuries. Conversely, others suggest safety wire itself may increase the risk of ureteral injuries that its routine use is not mandatory in all cases. This randomized clinical trial was conducted to compare the outcome of TUL in the presence or absence of a safety guidewire. Methods: This randomized clinical trial was conducted on patients referred to our center with a ureteral stone less than 1.5 cm; candidate for TUL after not passing the stone after 2 weeks of conservative management and had no sign of infections or anatomic abnormalities. The primary outcome was the rate of ureteral injuries. Patients were randomly divided into two groups; using safety wire (SGW) and not using safety wire (NSGW). Patients, the data collecting physician, and the Statistical analyst; were concealed from the randomization process. Demographic factors were recorded for each participant. Patients were followed up for at least 1 month; registering intra-operative and post-operative complications. Results: From 2020 to 2021, 348 patients were randomized in two arms. Considering the lost cases during the study, 124 patients were finally analyzed in the SGW and 96 patients in the NSGW. Complications were not different between the two groups ( p > 0.05); though, operation time was significantly longer in the SGW group (31.7 min in SGW vs 28 min in NSGW p = 0.02) Conclusion: The safety guidewire seems to add no significant benefit to the TUL procedure outcomes in uncomplicated cases.
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Affiliation(s)
- Pakmanesh Hamid
- Urology department, Shahid Bahonar Medical Center, Kerman university of medical sciences, Kerman, Iran
| | - Mohamadi Reza
- Urology department, Shahid Bahonar Medical Center, Kerman university of medical sciences, Kerman, Iran
| | - Kamalati Ali
- Urology department, Shahid Bahonar Medical Center, Kerman university of medical sciences, Kerman, Iran
| | - Danesh Pajoh Azar
- Urology department, Shahid Bahonar Medical Center, Kerman university of medical sciences, Kerman, Iran
| | - Behzadi Reza
- Urology department, Shahid Bahonar Medical Center, Kerman university of medical sciences, Kerman, Iran
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2
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Asali M. Sheathed flexible retrograde intrarenal surgery without safety guide wire for upper urinary tract stones. Arch Ital Urol Androl 2022; 94:186-189. [PMID: 35775345 DOI: 10.4081/aiua.2022.2.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 05/27/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To assess the success rate and intraoperative complications of flexible ureterorenoscopy (f-URS) in patients with upper urinary tract (UUT) stones using a ureteral access sheath (UAS) without a safety guide wire (SGW). PATIENTS AND METHODS Between April 2010 and March 2022, 464 renal units in patients with renal stones with and without concomitant ureteral stones (UUT), underwent ureterorenoscopy by one surgeon, and UAS was used in all of them. The primary endpoint was the stone-free rate (SFR). SFR was defined as no residual fragments at all. The following characteristics were examined: age, sex, laterality, renal/ureteral stones, stone diameter, SFR, Hounsfield unit, auxiliary procedures, double-J stent insertion, and intraoperative complications. This study was retrospective, with all the data recorded prospectively. Patients with residual stones were scheduled for the 2nd RIRS. The Clavien-Dindo classification was used to report complications. RESULTS The mean patient age was 52.9 years. The mean stone size was 13.1 mm. Lower pole, upper and middle calyces, renal pelvis and ureteral stones were found in 51.5% (239), 34.9% (162), 18.3% (85) and 46.9% (218) of cases, respectively. The mean diameter was 8.1 mm, 8 mm, 12.5 mm and 8.1 mm for the lower pole, upper and middle calyces, renal pelvis and ureteral stones, respectively. The single- and second-session SFRs were 90% and 100%, respectively. The mean number of procedures per renal unit was 1.1. Ureteral double-J stents were inserted in 45.7% (212) of patients. In 96 cases, a stent was placed before surgery. Postoperative complications were minor, with no avulsion or perforation of the ureters; readmission and insertion of a DJ stent occurred in one patient. Ureteral stricture developed in one patient (0.2%) and needed treatment with laser ureterotomy. CONCLUSIONS f-URS is a safe and effective mode of surgical management of renal and simultaneous renal and ureteral calculi using the ureteral access sheath without a safety guide wire. A guide wire should not be routinely used in these cases.
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Affiliation(s)
- Murad Asali
- Urology Department, Barzilai Medical Center, Ben Gurion University of the Negev, Beer Sheva; Assuta Medical Center, Beer Sheva, Ramat Hyal, Ben Gurion University of the Negev, Beer Sheva.
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3
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Hori S, Otsuki H, Fujio K, Nakajima K, Mitsui Y. Impact of eliminating urethral catheterization following ureterorenoscopic lithotripsy. Int J Urol 2022; 29:337-342. [PMID: 35028967 DOI: 10.1111/iju.14782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 12/14/2021] [Accepted: 12/19/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To show that elimination of a urethral catheter in ureterorenoscopic lithotripsy cases is not disadvantageous. METHODS We reviewed 164 non-catheterized patients (experimental group) and 656 catheterized patients (control group) with renal or ureteral stones treated at our institution. Inclusion criteria were initial operation, patient age 18 to 75 years, no dysuria, and no preoperative febrile urinary tract infection due to calculi. The primary areas of evaluation were patient background, stone characteristics, perioperative factors, and postoperative evaluation results. RESULTS The proportion of women was significantly lower (24.4% vs 37.2%; P = 0.01) and the proportion of multiple stone cases was significantly higher (34.9% vs 19.2%; P < 0.001) in the experimental as compared to the control group, while there were no significant differences for patient background or stone characteristics. The percentages of short-term preoperative stent insertion (72.0% vs 33.0%; P = 0.009) and negative preoperative urine culture cases (58.0% vs 23.0%; P < 0.001) were significantly higher in the experimental than in the control group, with no differences regarding other perioperative factors. There was no significant difference for complete stone clearance rate between the groups (P = 0.339), while only one patient underwent re-catheterization and there were no cases of urinary retention. Interestingly, the rate of postoperative febrile urinary tract infection was significantly lower (P = 0.024) in the experimental (5.7%) than in the control (9.0%) group. CONCLUSION Postoperative urethral catheterization can be eliminated in low-risk ureterorenoscopic lithotripsy cases, although additional studies are needed.
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Affiliation(s)
- Shunsuke Hori
- Department of Urology, Toho University Faculty of Medicine, Tokyo, Japan.,Department of Urology, Abiko Toho Hospital, Chiba, Japan
| | - Hideo Otsuki
- Department of Urology, Abiko Toho Hospital, Chiba, Japan
| | - Kei Fujio
- Department of Urology, Abiko Toho Hospital, Chiba, Japan
| | - Koichi Nakajima
- Department of Urology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Yozo Mitsui
- Department of Urology, Toho University Faculty of Medicine, Tokyo, Japan
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Gökce Mİ, Babayiğit M, Kubilay E, Aydoğ E, Oktar A, Akpınar Ç, Süer E, Gülpınar Ö. Is it necessary to have a guidewire down through the ureter during mini percutaneous nephrolithotomy? Single-centre experience with 1052 cases. Int J Clin Pract 2021; 75:e14430. [PMID: 34080262 DOI: 10.1111/ijcp.14430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/18/2021] [Accepted: 05/31/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES In this study, it is aimed to identify the rate of successful placement of a guidewire down through the ureter during PNL and to compare the outcomes of different locations of guidewires in the collecting system following renal puncture in terms of success and complications rates. PATIENTS AND METHODS Data of 1052 patients who underwent miniPNL in our institution between January 2014 and November 2020 were analysed. Patients were divided into three groups. Group I consisted of patients with the guidewire coiled within the punctured calyx, group II consisted of patients with the guidewire reaching the renal pelvis and group III consisted of patients with the guidewire passed down through the ureter. The groups were compared for successful tract creation and complication rates. RESULTS There were 303 (28.8%) patients in group I, 330 (31.4%) patients in group II and 419 (39.8%) patients in group III. Successful tract dilation at the first attempt was established in 298 (94.7%) patients in group I, 328 (99.4%) patients in group II and in all of the 419 (100%) patients in group III. Successful tract creation was established in a second attempt in all of the patients failed in the first attempt. The groups were similar for stone-free and complication rates. CONCLUSIONS Placement of guidewire down through the ureter could not be established in more than 60% of the cases. Location of guidewire prior to dilation did not affect the outcomes. Therefore, we suggest to proceed with tract creation even when the guidewire coils within the punctured calyx.
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Affiliation(s)
- Mehmet İlker Gökce
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Muammer Babayiğit
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Eralp Kubilay
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Ezel Aydoğ
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Alkan Oktar
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Çağrı Akpınar
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Evren Süer
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Ömer Gülpınar
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
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Alhunaidi O, Ahmad AA, El-Nahas AR, Akroof B, Alamiri A, Al-Ajrawi F, Al-Terki A, El-Shazly M. Impact of case volume per year on flexible Ureteroscopy practice: an internet based survey. BMC Urol 2019; 19:134. [PMID: 31852477 PMCID: PMC6921597 DOI: 10.1186/s12894-019-0568-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 12/12/2019] [Indexed: 11/20/2022] Open
Abstract
Background To report current worldwide variation in techniques and clinical practice of flexible ureteroscopy (FURS) among endourologists of different case volumes per year. Methods Two invitations to complete an internet survey were emailed to Endourological Society members. Some of survey questions asked about indications of using FURS for renal and upper ureteral stones. Others were concerned with clinical practice of FURS (such as preoperative stenting, use of ureteral access sheath (UAS) and safety guidewire, technique of Laser lithotripsy and fragment retrieval, and post-FURS stenting. Responders were distributed into two groups; high-volume (> 100 cases/year) and low-volume surgeons (< 100 cases/year) and data were compared between both groups. Results Responses were received from 146 endourologists all over the world (62 high-volume and 84 low-volume). FURS for intrarenal stone > 20 mm was used by 61% of high-volume surgeons compared with 28.6% for low-volume (P < 0.001). Semirigid URS was used for upper ureteric stones in 68% among high-volume group and 82% in low-volume group (P = 0.044). UAS was used by 62% in low-volume group and 69% in high volume group (P = 0.516). Laser stone dusting was preferred by 63% in low-volume group versus 45% by high-volume (P = 0.031). More responders in low-volume group preferred to leave the stent for 6 weeks (P = 0.042). Conclusions The use of FURS for treating upper tract calculi has expanded by high volume endourologists to include large renal stones > 20 mm. Low-volume surgeons prefer to use semi-rigid URS for treatment of upper ureteral stones, to apply Laser stone dusting and maintain ureteral stents for longer periods.
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Affiliation(s)
- Omar Alhunaidi
- Urology Department, Al-Amiri hospital, Kuwait City, Kuwait
| | | | - Ahmed R El-Nahas
- Urology Department, Al-Amiri hospital, Kuwait City, Kuwait. .,Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
| | - Bader Akroof
- Urology Department, Al-Amiri hospital, Kuwait City, Kuwait
| | - Ali Alamiri
- Urology Department, Al-Amiri hospital, Kuwait City, Kuwait
| | - Feras Al-Ajrawi
- Urology Department, Al-Farwaniya hospital, Sabah Al Nasser, Kuwait
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Hosny K, Clark J, Srirangam SJ. Handling and protecting your flexible ureteroscope: how to maximise scope usage. Transl Androl Urol 2019; 8:S426-S435. [PMID: 31656748 DOI: 10.21037/tau.2019.07.08] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Flexible ureteroscopy is an important therapeutic and diagnostic procedure and has seen rapid rise in its utilisation in recent years. There have been numerous developments in flexible ureteroscope (fURS) technology but scope fragility, and the associated high maintenance costs, remains a concern. A comprehensive Medline search for related publications from the last 20 years was undertaken to identify common causes of fURS damage and ascertain practices to minimise this. Flexible ureteroscopy can be due to intraoperative causes (loss of the deflection mechanism, damage to the working channel due and fibreoptic bundle injury) and non-operative damage which occur during cleaning, sterilisation and handling of the fURS. The review summarises the available literature to help highlight common mechanisms of scope damage, and outlines evidence-based measures to reduce the risk of damage and maximise durability. Scope fragility remains a problem with significant associated cost implications. In a culture of rising fURS use and reducing re-imbursement for endourologists, prolonging the longevity of the fURS is imperative for maintaining profitability. There are simple and inexpensive practices which can be immediately adopted to maximise fURS use and reduce the need for repairs.
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Affiliation(s)
- Khaled Hosny
- Department of Urology, Royal Blackburn Teaching Hospital, East Lancashire Hospitals NHS Trust, Blackburn BB2 3HH, UK
| | - Jennifer Clark
- Department of Urology, Royal Blackburn Teaching Hospital, East Lancashire Hospitals NHS Trust, Blackburn BB2 3HH, UK
| | - Shalom J Srirangam
- Department of Urology, Royal Blackburn Teaching Hospital, East Lancashire Hospitals NHS Trust, Blackburn BB2 3HH, UK
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7
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Adam A. A guidewire on your fingertip: A novel innovative technique. AFRICAN JOURNAL OF UROLOGY 2018. [DOI: 10.1016/j.afju.2018.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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8
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Rodríguez-Monsalve Herrero M, Doizi S, Keller EX, De Coninck V, Traxer O. Retrograde intrarenal surgery: An expanding role in treatment of urolithiasis. Asian J Urol 2018; 5:264-273. [PMID: 30364659 PMCID: PMC6197554 DOI: 10.1016/j.ajur.2018.06.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 05/05/2018] [Accepted: 05/10/2018] [Indexed: 12/18/2022] Open
Abstract
During the past 3 decades, the surgical management of kidney stones has undergone many technological advances and one is the development of the flexible ureteroscopy. The development of this instrument as well as ancillary equipment such as baskets, graspers, and others, and improvements in lithotripsy with Holmium: YAG laser have led to expand its indications with diagnostic and therapeutic management of medical issues of the upper urinary tract such as urolithiasis and urothelial tumors. The objective of this review is to describe its indications and results in the different scenarios for the treatment of urinary stones.
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Affiliation(s)
| | - Steeve Doizi
- Department of Urology, Tenon Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Etienne Xavier Keller
- Department of Urology, Tenon Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Vincent De Coninck
- Department of Urology, Tenon Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Olivier Traxer
- Department of Urology, Tenon Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France
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9
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Identifying factors associated with need for flexible ureteroscope repair: a Western Endourology STone (WEST) research consortium prospective cohort study. Urolithiasis 2017; 46:559-566. [PMID: 29224057 DOI: 10.1007/s00240-017-1013-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 10/29/2017] [Indexed: 10/18/2022]
Abstract
Maintenance of flexible ureteroscopes can involve high costs and administrative burden. Instrument fragility necessitates eventual repair, rendering scopes inaccessible during refurbishment. We conducted a multi-institutional prospective cohort study to identify perioperative factors influencing flexible ureteroscope durability. Patients undergoing flexible ureteroscopy (URS) at six United States endourology centers were enrolled between August 2014 and June 2015. Surgeon self-reported concern and satisfaction with scope performance as well as upward and downward angles of deflection for each scope tip were measured before and after each procedure. The need for scope repair was determined by the operating surgeon at the time of the procedure and recorded. 424 URS cases using 74 flexible ureteroscopes were identified. Scope repair was required in 28 cases (6.6%) involving 26 scopes (35.1%). Upon univariate analysis, shorter patient height, absence of guidewire use, presence of a ureteral access sheath (UAS), longer procedure time, larger stone size, lithotrite type, surgeon training level, and self-reported concern were associated with scope repair. Upon multivariate analysis, UAS use (OR = 2.53, p = 0.005) and degree loss of scope upward flexion during a case (OR = 1.02, p = 0.03) increased the odds of a scope needing repair while the use of safety guidewire decreased the odds of a scope repair (OR = 0.50, p = 0.045). Lithotrite use and surgeon concern were associated with degree loss of scope upward flexion. The use of a UAS, absence of a safety guidewire, and the loss of upward ureteroscope flexion should be considered when evaluating means of optimizing reusable ureteroscope durability.
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10
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Doizi S, Traxer O. Flexible ureteroscopy: technique, tips and tricks. Urolithiasis 2017; 46:47-58. [PMID: 29222575 DOI: 10.1007/s00240-017-1030-x] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Accepted: 11/20/2017] [Indexed: 12/11/2022]
Abstract
During the last decades, the surgical management of kidney stones benefited of many technological advances and one of them is the development of flexible ureteroscopy (fURS). This tool, ancillary equipment such as graspers and baskets, and lithotripsy technique with Holmium:YAG laser underwent many improvements leading to a widening of its indications with diagnostic and therapeutic management of upper urinary tract pathologies such as urolithiasis and urothelial tumors. The objective of this review is to describe the surgical technique for fURS as well as tips and tricks for the treatment of renal stones.
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Affiliation(s)
- Steeve Doizi
- Department of Urology, Tenon Hospital, Assistance-Publique Hôpitaux de Paris, 4 rue de la Chine, 75020, Paris, France.,Pierre et Marie Curie University, Paris, France.,Groupe de Recherche Clinique sur la Lithiase Urinaire, Tenon Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Olivier Traxer
- Department of Urology, Tenon Hospital, Assistance-Publique Hôpitaux de Paris, 4 rue de la Chine, 75020, Paris, France. .,Pierre et Marie Curie University, Paris, France. .,Groupe de Recherche Clinique sur la Lithiase Urinaire, Tenon Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
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11
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Osther PJS. Risks of flexible ureterorenoscopy: pathophysiology and prevention. Urolithiasis 2017; 46:59-67. [PMID: 29151117 DOI: 10.1007/s00240-017-1018-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 11/11/2017] [Indexed: 11/26/2022]
Abstract
Currently, indications for flexible ureterorenoscopy (fURS) are expanding, mainly due to technological advancements. Although data from clinical series definitely presents fURS as a safe procedure, serious complications including sepsis and ureteral lesions do occur. These complications seem to be a result of the unique elements of fURS, ureteral access and irrigation, pushing normal upper urinary tract physiology into pathophysiological processes, including intrarenal/pyelo-veneous backflow and ureteral contractions, potentially resulting in septic, haemorrhagic and ureteral lesional complications. Knowledge on normal upper urinary tract physiology are crucial for understanding how these harmful effects of fURS may be avoided or minimized. The pathophysiology of intrarenal pressure increases and ureteral access will be discussed as a basis for understanding preventive measures. Role of antibiotics, ureteral access sheaths, safty guidewires, pain medication, prestenting and pharmacologic modulation of pyeloureteral dynamics are reviewed from a pathophysiological perspective.
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Affiliation(s)
- Palle J S Osther
- Urological Research Center, Department of Urology, Lillebaelt Hospital, Beridderbakken 4, 7100, Vejle, Denmark.
- Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Vejle, Denmark.
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Inoue T, Okada S, Hamamoto S, Yoshida T, Matsuda T. Current trends and pitfalls in endoscopic treatment of urolithiasis. Int J Urol 2017; 25:121-133. [DOI: 10.1111/iju.13491] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 10/12/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Takaaki Inoue
- Department of Urology and Andrology; Kansai Medical University; Hirakata Osaka Japan
| | - Shinsuke Okada
- Department of Urology; Gyotoku General Hospital; Ichikawa Chiba Japan
| | - Shuzo Hamamoto
- Department of Urology; Medical School; Nagoya City University Graduate School of Medical Sciences; Nagoya Aichi Japan
| | - Takashi Yoshida
- Department of Urology and Andrology; Kansai Medical University; Hirakata Osaka Japan
| | - Tadashi Matsuda
- Department of Urology and Andrology; Kansai Medical University; Hirakata Osaka Japan
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13
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Hernández RP, Caballero Romeu JP, Galiano Baena JF, Montoya Lirola MD, García Tabar PJ, Galán Llopis JA, Gonzálvez Piñera J, Mira Marcelí NA, Budía Alba A. Technical considerations about micro-ureteroscopy in children. J Pediatr Surg 2017; 52:1216. [PMID: 28431736 DOI: 10.1016/j.jpedsurg.2017.03.053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 03/07/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Rebeca Polo Hernández
- Department of Urology, University General Hospital of Alicante, Pintor Baeza 12, Alicante 03010, Spain.
| | | | | | | | - Pedro José García Tabar
- Department of Urology, University General Hospital of Alicante, Pintor Baeza 12, Alicante 03010, Spain
| | - Juan Antonio Galán Llopis
- Department of Urology, University Hospital of Vinalopo, Tonico Sansano Mora 14, Elche, 03293, Alicante, Spain
| | - Jerónimo Gonzálvez Piñera
- Department of Pediatric Surgery, University General Hospital of Alicante, Pintor Baeza 12, Alicante 03010, Spain
| | - Nuria Albertos Mira Marcelí
- Department of Pediatric Surgery, University General Hospital of Alicante, Pintor Baeza 12, Alicante 03010, Spain
| | - Alberto Budía Alba
- Department of Urology, "La Fe" Polytechnic University Hospital in Valencia, Fernando Abril Martorell 106, Valencia 46026, Spain
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Abstract
Ureterorenoscopy (URS) is a minimally invasive treatment option for removal of kidney stones, which has gained importance in this field over the past two decades. This technique has replaced extracorporeal shock wave lithotripsy (ESWL) stone surgery for many indications. It is also particularly important in the diagnostics and treatment for tumors of the upper urinary tract. This article describes the indications, surgical technique and management of complications of URS.
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