Comparison of retrograde ureterorenoscopy (URS) and percutaneous anterograde ureteroscopy for removal of impacted upper ureteral stones >10mm in the elderly population

Abstract

Purpose: We aimed to compare the success and complication rates of the anterograde and retrograde Ureterorenoscopy (URS) for impacted upper ureteral stones in patients > 65 years of age. Materials and Methods: Data of 146 patients >65 years of age and underwent anterograde URS (n=68) in supine position or retrograde URS (n=78) for upper ureteral impacted stones>10 mm between January 2014 and September 2018 were collected prospectively. The groups were compared for success and complication rates, duration of operation, hospital stay, and ancillary procedures. Results: Anterograde and retrograde URS groups were similar for demographic and stone related characteristics. The success rate of the anterograde URS group was signifi cantly higher than the retrograde URS group (97.1% vs. 78.2%, p=0.0007). The complication rates were similar for the two groups (p=0.86). Clavien grade I and II complications were observed in 3 patients in each group. The mean hemoglobin drop was 0.5 g/dL in the anterograde URS group and blood transfusion was not performed in any of the patients. The mean duration of operation was 41.2±12.5 minutes in the mini-PNL group and 59.6±15.1 minutes in the RIRS group and the difference was statistically signifi cant (p=0.02). The median duration of hospitalization was 1 day for both groups. Conclusions: Performing anterograde URS in supine position provided better success rates and similar complication rates compared to retrograde URS. Based on these results anterograde URS shall be considered as one of the primary treatment options for management of impacted upper ureteral stones in the elderly population.

A Comparative Analysis between Flexible Ureteroscopic Lithotripsy and Tubeless Percutaneous Nephrolithotomy in the Treatment of >15 mm Non-Obstructing Proximal Ureteral Stones

“…However, the overall SFR at the 1-month followup after initial operation was 100% in the mini-PNL group and 89.7% in the URSL group (p = 0.07). Comparison study between retrograde URL and percutaneous anterograde URL for removal of impacted upper ureteral stone >1 cm in patients > 65 years of age was executed in 2021 [25]. The authors commented that the success rate of the anterograde URL was significantly higher than that of the retrograde URL group (p = 0.0007).…”

Comparison of minimally invasive percutaneous nephrolithotomy and ureteroscopy in the management of impacted proximal ureteral stones

“…Въпреки това средният болничен престой при двете групи пациенти е 6,3 дни при PCNL и 2,1 дни при URS, сравнително по-дълъг престой в сравнение с нашата кохорта [7]. В проучване на Gokce et al, се докладва значително по-кратък болничен престой (1 ден), поради факта на "tubeless" процедурите при всички пациенти в неговата серия [24].…”

Predictive model for urosepsis in patients with Upper Urinary Tract Calculi based on ultrasonography and urinalysis using artificial intelligence learning

“…Upper urinary tract obstruction caused by calculi is an important cause of urosepsis (5). Currently, most of the studies focus on the risk factors of urosepsis following endoscopic lithotripsy (6)(7)(8). However, in the clinic, many patients are diagnosed with upper urinary tract calculi complicated with urosepsis before or after admission (9).…”