Effectiveness of Single Flexible Ureteroscopy for Multiple Renal Calculi

Herrera-Gonzalez, Gerardo; Netsch, Christopher; Oberhagemann, K.; Bach, Thorsten; Gross, Andreas J.

doi:10.1089/end.2010.0233

Cited by 31 publications

(26 citation statements)

References 33 publications

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“…Score. The number of stones has been shown to be significant in other studies (21). A number of methods have been developed to describe stone burden by incorporating both the size and number of stones (21,22).…”

Section: Discussionmentioning

confidence: 99%

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The S.T.O.N.E. Score: A new assessment tool to predict stone free rates in ureteroscopy from pre-operative radiological features

et al. 2014

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Section: Discussionmentioning

confidence: 99%

“…The number of stones has been shown to be significant in other studies (21). A number of methods have been developed to describe stone burden by incorporating both the size and number of stones (21,22). The description of total stone burden applies two dimensional measurements using rectangular and elliptical approximations (18).…”

Section: Discussionmentioning

confidence: 99%

The S.T.O.N.E. Score: A new assessment tool to predict stone free rates in ureteroscopy from pre-operative radiological features

et al. 2014

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“…Recent advances such as the miniaturization of the ureteroscopes, improvements of deflection and durability of flexible ureterorenoscopes as well as the improvement of stone disintegration using laser lithotriptors accordingly expanded the indications for URS to ureteroscopic treatment of larger-sized ureteral and kidney stones and multiple intrarenal stones, respectively [1,2,3,4,5,14,15,16,17,18,21]. However, ureteroscopy, especially when combined with laser lithotripsy, may cause severe complications (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…The occurrence of complications is stated to depend on various factors, such as stone size, stone width in ureteral stones, stone location, ureteral stone impaction and surgeon's or department's experience [8,9,10,11,12,13]. URS has also been successfully applied on larger-sized or multiple calculi of the upper urinary tract [14,15,16,17,18], which otherwise extends the duration of the URS procedure significantly. Longer duration of the URS procedure has however been shown to be strongly associated with ureteral perforation [10].…”

Section: Introductionmentioning

confidence: 99%

Is Prolonged Operation Time a Predictor for the Occurrence of Complications in Ureteroscopy?

et al. 2015

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Objective: To determine the impact of duration of ureteroscopy for urolithiasis on complication rates (CRs) of the procedure. Methods: A retrospective analysis of 2,010 patients, treated between 2006 and 2011, was done. The operation time (OT) and the occurrence of complications were compared. Results: The overall CR was 14.3% [298 complications, minor complications (Clavien I-II) 91.7%]. The median OT was 35 min [interquartile range (IQR) 20-61]. The OT differed significantly between those without complications [34 min (IQR 20-60)] and those with complications [45 min (IQR 25-76)] (p < 0.0001). The correlation between the OT and the occurrence of complications (r = -0.009648, p < 0.0001) was very weak and passed the level of significance (r = 0.2). The effect size was of minor relevance (Cohen's d = 0.27972). Conclusions: Longer OT correlates significantly with a higher CR. The effect is however shown to be minor and the overall rate of complications, especially severe ones, is low.

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“…With PCNL and ESWL, there is also a need for multiple interventions for multiple renal stones in different locations. Although only a few studies have evaluated RIRS for the treatment of multiple renal stones, they have reported low interventions with high success rates (3,4,5,6,7).…”

Section: Introductionmentioning

confidence: 99%

Utility of Flexible Ureterorenoscopy and Laser Lithotripsy in the Treatment of Multiple Intrarenal Stones

Yılmaz¹,

Sarıbacak²

2017

jus

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ÖzAmaç: Multipl böbrek taşlarının tedavisinde fleksibl üreterorenoskopi ile birlikte Holmium lazer kullanımını etkinlik ve güvenlik açısından değerlendirmeyi amaçladık. Gereç ve Yöntem: Kliniğimizde multipl böbrek taşı nedeni ile tek cerrah tarafından fleksibl üreterorenoskopi ve lazer litotripsi yapılan 32 hasta retrospektif olarak değerlendirildi. Hastaların yaşı, cinsiyeti, vücut kitle indeksi, operasyon süresi, taşlarının yeri, boyutu, sayısı, yükü, taşsızlık oranı ve komplikasyonlar kaydedildi. Taş yükü böbrek içindeki taşların uzunlukları toplamı olarak hesaplandı. Taşsızlık, operasyon sonrası 3. ayda taş olmaması veya böbrek içinde <3 mm taş olması olarak değerlendirildi. Bulgular: Ortanca hasta yaşı 38 [çeyrekler arası aralık (IQR), 34,25-52,00] yıl idi. Hastalarda toplam 75 intrarenal taş vardı. Hasta başı ortanca taş sayısı ve taş yükü sırasıyla 2,50 (IQR, 2,0-3,0) 50 ve 23,0 mm (IQR, 19,0-28,0 mm) idi. Hastaların 21'inde (%65,5) taş yükü >20 mm iken 11 (%34,5) hastanın ≤20 mm idi. Toplam taşsızlık oranı %78,1 idi. Bu oran taş yükü ≤20 mm ve >20 mm olan hastalarda sırasıyla %81,8 (9/11) ve %76,2 (16/21) idi (p=0,544). Bir hastada operasyon sırasında idrar kaçağına neden olan üreter perforasyonu gelişti, double-J kateter ile tedavi edildi. Dört hastada (%12,5) postoperatif komplikasyon izlendi (iki hasta paranteral tedavi gerektirecek ağrı, bir hastada hematüri, bir hastada ise idrar yolu enfeksiyonu). Objective:We aimed to determine the safety and efficacy of flexible ureterorenoscopy and Holmium laser lithotripsy in treating multiple intrarenal stones. Materials and Methods:We identified 32 consecutive patients with multiple intrarenal stones who underwent flexible ureterorenoscopy and/or laser lithotripsy performed by a single surgeon. Informed consent was obtained from all participants before treatment. Each patient was evaluated in terms of stone location, stone number, stone size, stone burden (cumulative stone length), body mass index, operative time, stone-free rate, and perioperative complications. Results: The median age of the patients was 38 years [interquartile range (IQR), 34.25-52.00]. The patients had a total of 75 intrarenal calculi. The average number of stones per patient was 2.50 (IQR, 2.0-3.0). The median total stone burden per patient was 23.0 mm (IQR, 19.0-28.0 mm). Twenty-one patients (65.5%) had stone burdens >20 mm, and 11 (34.5%) had burdens ≤20 mm. The overall final stone-free rate was 78.1%. The stone-free rates for patients with stone burdens ≤20 mm and >20 mm were 81.8% (9/11) and 76.2% (16/21), respectively (p=0.544). A perioperative complication (urinary leakage) occurred in one patient. Postoperative complications were recorded in four (12.5%) patients; a urinary tract infection in one, pain requiring parenteral medication in two, and hematuria in one. Conclusion: Flexible ureterorenoscopy combined with laser lithotripsy may be an effective treatment option for patients with multiple intrarenal stones; we noted only a few minor complications. The success rate was higher...

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Effectiveness of Single Flexible Ureteroscopy for Multiple Renal Calculi

Abstract: fURS is an effective treatment option in patients with multiple unilateral renal stones. Single procedure stone-free rates are high with a low rate of only minor complications.

Cited by 31 publications

References 33 publications

The S.T.O.N.E. Score: A new assessment tool to predict stone free rates in ureteroscopy from pre-operative radiological features

The S.T.O.N.E. Score: A new assessment tool to predict stone free rates in ureteroscopy from pre-operative radiological features

Is Prolonged Operation Time a Predictor for the Occurrence of Complications in Ureteroscopy?

Utility of Flexible Ureterorenoscopy and Laser Lithotripsy in the Treatment of Multiple Intrarenal Stones

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