Complications of ureteroscopic stone lithotripsy: A multicentre local study

Almusafer, Murtadha; Al-Tawri, Ali Mohammed Jawad

doi:10.4103/hmj.hmj_73_18

Cited by 3 publications

(6 citation statements)

References 32 publications

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“…In the present study, similar percentages of this complication was found in both groups (3.8%). In a larger cohort, Kilinc et al (18) reported a percentage of 0.36% in patients who received URS after lithotripsy and 0% in patients who received URS per primam, while Almusafer and Jawad Al-Tawri yielded a percentage similar to ours, i.e., 2.25% (27). Geavlete et al (25) estimated that false passage occurs in 1% of the first-intention ureteroscopies, whether it be diagnostic or therapeutic.…”

Section: Resultssupporting

confidence: 53%

“…From this point of view, Irer described equal calculus migration percentages in patients who received first-intention URS as well as in patients in which URS followed extracorporeal lithotripsy (2.4%), although higher percentages of calculi migration to the calyx were reported (10). Findings of a previous study showed percentages of 14.4% in the case of impacted calculi and 7.9% in the case of non-impacted calculi, thereby affirming that the degree of the calculus entrenchment is an important predictive factor regarding the risk of proximal migration (27).…”

Section: Resultsmentioning

confidence: 90%

“…Ibrahim (26) in a group of 148 patients who received URS, reported superficial ureteral lesions on 9.5% of patients. Almusafer and Al-Tawri (27) found that 11 out of 18 patients (57.9%) who received SWL before URS, suffered ureteral mucosa abrasions, while Fuganti et al (28), on a cohort of 1,235 ureteroscopies, reported an almost similar percentage of minor ureteral lesions, namely 61.8%. A study conducted by Ogreden et al (29) on early URS for distal ureteral stones highlighted the efficiency of this procedure in experienced hands with rather low complication rates, similar to our study.…”

Section: Resultsmentioning

confidence: 97%

“…A higher percentage, similar to the one reported by us, was also found by Ogreden et al (28) who identified 4.6% ureteral perforations on a group of 811 patients, while at the opposite end is Philippou et al (19) who reported 0% ureteral perforations. In addition, in a comparative study, Almusafer and Jawad Al-Tawri (27) reported an 8.6 and 1.5% incidence of minor and major ureteral violence, respectively. In our groups of patients, these minor perforations did not require nephrostomy insertion or open surgery, the solution chosen by the placement of a JJ stent.…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Determining whether previous SWL for ureteric stones influences the results of ureteroscopy as the second‑line treatment: A clinical study

et al. 2021

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Section: Resultssupporting

confidence: 53%

Section: Resultsmentioning

confidence: 90%

Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Determining whether previous SWL for ureteric stones influences the results of ureteroscopy as the second‑line treatment: A clinical study

et al. 2021

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“…Recently, the widespread use of flexible and semi-rigid ureteroscopes with narrow diameters has improved ureteroscopy (URS) outcomes for urolithiasis (1,2). Many factors influence URS outcome for ureteral stones, including stone size, stone composition, patient background, device availability, and history of extracorporeal shockwave lithotripsy (3)(4)(5). Reports on the outcomes of middle ureteral stones are controversial.…”

Section: Introductionmentioning

confidence: 99%

The lumbosacral angle is a significant predictor for using a semi-rigid ureteroscopic approach in middle ureteral stones

Ueki

Inoue

Fujita³

et al. 2022

Transl Androl Urol

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Background: Ureteroscopy for middle ureteral stones is often difficult from an anatomical view. This study aimed to evaluate the pelvic anatomy in three dimensions and investigate the relationship between the pelvic anatomy and potential semi-rigid ureteroscopic approach for treating middle ureteral stones.Methods: From a total of 967 patients who underwent ureteroscopy from December 2017 to January 2021, 124 patients who had middle ureteral stones were included in this retrospective cohort study. The pelvic transverse diameter, pelvic vertical diameter, pelvic depth, and lumbosacral angle were measured through preoperative non-contrast computed tomography to define the shape of the pelvic cavity. The relationship between the reachability of the middle ureteral stone using a semi-rigid ureteroscope and the aforementioned anatomical factors, as well as treatment outcomes, was examined retrospectively. Results:The lumbosacral angle and female sex were significant predictors of the possibility of a semi-rigid ureteroscopic approach to middle ureteral stones [odds ratio =1.08; 95% confidence interval (CI): 1.03-1.14; P=0.003, and odds ratio =3.23; 95% CI: 1.12-9.32; P=0.03, respectively]. The cutoff value of the lumbosacral angle was 149.9°, with a sensitivity of 55.1% and a specificity of 72.7%. The time to reach the stone was longer in the lumbosacral angle <150° group than in the lumbosacral angle ≥150° group (P=0.049).Conclusions: In this study, gradual lumbosacral angle and female sex are positive predictors of the reachability of the middle ureteral stone with a semi-rigid ureteroscope.

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Second-look flexible ureteroscopy after RIRS – Holmium Moses versus TFL (Soltive)

Geavlete¹,

Mareș²,

Multescu³

et al. 2022

JMedLife

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Retrograde intrarenal surgery (RIRS) is nowadays more and more indicated in pyelocaliceal stones. Holmium and Thulium lasers are the main lasers used. Fragmenting (basketing) or dusting, despite the new technology, still have residual stones (even having 250 microns). This study evaluates second-look flexible ureteroscopy for residual fragments. We analyzed 246 patients (October 2020–March 2022) on which we used Moses Holmium technology (187 cases) in Group 1 and Soltive Laser System (59 cases) in Group 2. The average stone size was 13.1 mm (range 11–29), and the average stone density was 1026 HU (range 870–1752). We used 270 µm for Ho: YAG laser and 150 µm for TFL. For Holmium, we applied energy 0.4J and frequency 80 Hz. For TFL, we applied fine dusting (0.15 J/100 Hz) and dusting (0.5 J/30 Hz). After three months, we practiced the second flexible ureteroscopy. Both groups were compared for completely visual stone-free rates. Stone-free rate at 3 months (second flexible ureteroscopy) was 86.63% (n=162/187) in Group 1 and 96,61% (n=57/59) in Group 2, respectively. The stone-free correlation with the CT preoperative evaluation was 160/187–85.56% for Holmium and 55/59–93.22% for TFL. We found residual stones after the second flexible ureteroscopy in 25 cases after Holmium laser treatment and only in 2 cases after TFL. In all these cases, we finally obtained zero residual stones. The second flexible ureteroscopy could achieve complete residual stone removal and real stone-free status. Despite a slight difference between these two laser technologies, the second look decreases the residual fragments.

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Complications of ureteroscopic stone lithotripsy: A multicentre local study

Cited by 3 publications

References 32 publications

Determining whether previous SWL for ureteric stones influences the results of ureteroscopy as the second‑line treatment: A clinical study

Determining whether previous SWL for ureteric stones influences the results of ureteroscopy as the second‑line treatment: A clinical study

The lumbosacral angle is a significant predictor for using a semi-rigid ureteroscopic approach in middle ureteral stones

Second-look flexible ureteroscopy after RIRS – Holmium Moses versus TFL (Soltive)

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