Flexible ureterorenoscopy in position or fusion anomaly: Is it feasible?

Abstract

Objective: To analyze the results of flexible ureterorenoscopy (F-URS) with holmium laser in the treatment of kidney stones with ectopic and fusion anomalies (horseshoe kidney and rotation anomalies). Method: We reviewed data from 13 patients with fusion and ectopic renal anomalies that underwent F-URS from April 2011 to April 2017. We analyzed demographic and clinical data (age, gender, BMI, anatomical abnormality, location and dimension of the renal calculi) and perioperative data (method of treatment, stone-free rate, number of days with DJ catheter and perioperative complications). Results: The mean stone size was 12.23 +/-5.43 mm (range 6-22mm), located in the inferior (58.33%) and middle (16.76%) calyceal units, renal pelvis (16.67%) and multiple locations (8.33%). All 13 patients were treated with Ho-Yag laser, using dusting technique (25%), fragmentation and extraction of the calculi (58.33%) and mixed technique (16.67%). We did not have any severe perioperative complication. After 90 days, nine patients (75%) were considered stone free. Conclusion: Our data suggest that F-URS is a safe and feasible choice for the treatment of kidney stones in patients with renal ectopic and fusion anomalies.

Retrograde intrarenal surgery for management of kidney stones smaller than 20 mm: A singe center experience of 452 cases

“…Patients' demographic data are summarized in Table 1.The mean stone size was 13.5 mm (range 7-20 mm). The mean stone sizes were 13.6 (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) 33.8%), and multiple calyces (n=88; 19.4%). Patients' stone characteristics are summarized in Table 2.…”

“…When reviewing the literature, Eryildirim et al retrospectively evaluated the results of RIRS they carried out on 50 cases with horseshoe kidneys [15] . Astolfi et al performed RIRS on 13 patients with fusion and ectopic renal anomalies [16] . In both studies, RIRS was indicated as a safe and feasible choice for the treatment of kidney stones in patients with renal ectopic and fusion anomalies.…”

Outcomes of ureteroscopy for stone disease in anomalous kidneys: a systematic review

“…The underlying renal anomaly was HSK (n = 204), EK (n = 117), MR (n = 86), cross fused ectopia (n = 2) and others (n = 4). The majority of these studies (n = 13) were retrospective with just one prospective study [26] (Table 1).…”

“…While semirigid URS was used in 41 (10%) cases, FURS was used in 90% of cases. Of the reported studies, a preoperative stent was reported in 26.4% (range 12.4-84.6%, 40/136 patients) [13][14][15][24][25][26]. Placement of ureteral access sheath (UAS) was reported in 11 studies [13-19, 21, 22, 24, 25].…”

“…The mean operative time was 61.3 min (range 14-185 min). While six studies report a post-operative stent placement in all of their patients [13,14,19,21,22,26], in the remaining studies this varied from 46.2 to 84% and was at the surgeon's discretion [15][16][17][23][24][25]. The mean hospital stay across studies was 1.7 days (range 0.5-9 days) ( Table 4).…”