Flexible Ureteroscopic Lithotripsy: First-Line Therapy for Proximal Ureteral and Renal Calculi in the Morbidly Obese and Superobese Patient

Abstract

In the morbidly obese patient with symptomatic stones <1.5 cm, ureteroscopic lithotripsy is safe, successful, and efficient.

Ureteral Access Sheath Provides Protection against Elevated Renal Pressures during Routine Flexible Ureteroscopic Stone Manipulation

“…[1][2][3][4][5][6][7][8] Of late, adjuncts to facilitate flexible ureteroscopy, including the UAS, have become commonplace, allowing a more rapid procedure while reducing patient morbidity and costs. [9][10][11] Not only does the access sheath enhance placement and withdrawal of the fragile flexible ureteroscopes, thereby maximizing instrument longevity, but the sheath also diverts the irrigation fluid stream externally to drain the majority of irrigant and decrease the requirement for intermittent bladder drainage during the procedure.…”

The clinical research office of the endourological society percutaneous nephrolithotomy global study: Outcomes in the morbidly obese patient – a case control analysis

“…The feasibility, success and safety of ureteroscopic management of both ureteric and renal calculi in obese patients has been described. 26 Particularly in the context of stones less than 2 cm in size, ureteroscopy offers several benefits, including less risk of hemorrhagic complications and the ability to perform the procedure in the dorsal lithotomy position under neurolept anesthesia on an outpatient basis. The utility of this approach for larger stones remains less well-defined, although in small series has been associated with stone-free rates after a single treatment session of up to 60%.…”

The Impact of Body Mass Index on the Outcomes of Retrograde Intrarenal Stone Surgery

“…Our SFR and complication rates are similar to the rates in the previously published articles reporting on RIRS outcomes in obese patients. 24,25 At the other site, our SFR after the procedures were determined with KUB and renal USG postoperatively, which may miss some residual fragments in obese patients. Thereby, the SFR may be overestimated and the rate of additional treatments may be lowered for the obese group.…”