Single or multi-stage retrograde ureteroscopic lithotripsy is a safe and effective mode of surgical management of large renal calculi. Total stone burden is a reliable predictor of the need for a staged procedure and of stone-free rate.
dorsal part of the limbs. Ureteral stents are placed and brought out through the abdominal wall. Anterior plate is finally sutured.RESULTS: Mean age was 64.5 years . Seventeen out of 20 patients were males; 3 were females. One non-surgical intraoperative complication (myocardial infarction requiring an acceleration of operative time) was recorded. During post-op course, two cases of urinary leakage at the neovescical-urethral anastomosis were evident and required prolonged catheterization. Mean length of stay was 17 days (12-27), excluding a single case of prolonged hospitalization due to C. Albicans superinfection. The 30-day readmission rate was 20% (4/20) due to febrile urinary tract infections; 90-day readmission rate was just 5% (1 symptomatic lymphocele requiring percutaneous drainage). Most male patients (14/17) reported daytime continence with insignificant post-voided residual. Between those patients in which nerve-sparing approach was pursued e and have more than 90 days of follow up e 3/5 referred potency. Regarding female patients, incomplete voiding is reported in a case and urinary incontinence (2 pads/day) in another.CONCLUSIONS: Intracorporeal neobladder reconstruction is a complex procedure even for expert robotic surgeons. Nevertheless, the standardization of the surgical approach e as displayed in the video e facilitates a rapid implementation of the procedure with positive surgical and clinical outcomes.
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