How Effective Is Retrograde Semirigid and Flexible Ureteroscopic Lithotripsy for the Treatment of Large Ureteral Stones Equal of or Greater than 15 mm? Results from a Single Center

Abstract

Purpose: To present the results and complications of retrograde ureteroscopic lithotripsy for treatment of large ureteral stones. Methods: Nineteen patients were treated for ureteral stones ≥15 mm detected in CT or plain KUB film. Endoscopy was performed with either a semirigid or flexible ureteroscope. Stone fragmentation was performed using a 30 W Holmium laser. Results: The mean stone size was 20.7 mm (range 15–30). The mean duration of the operation was 82 min (45–140). Measures to prevent retropulsion of fragments into the kidney were not routinely applied. A subsequent RIRS during the same session was necessary in 2 cases. After a single procedure a stone free state was achieved in 15 cases (78.9%), while 4 others required a second session (ESWL or second ureterolithotripsy, 2 cases each). In only 1 patient, the stone-free state was not achieved after a 1.2 procedure per patient (overall success rate 94.7%). The mean duration of hospitalization was 1.9 days (range 1–5). Three patients experienced postoperative pyelonephritis and 2 others prolonged hematuria. Conclusion: Endoscopic lithotripsy is safe and effective in treating large ureteral stones. After a single endoscopic procedure, approximately 4 out of 5 patients are expected to become stone free. This rate increases to 95% with a second session of lithotripsy.

Holmium laser lithotripsy with semirigid ureterorenoscopy in treatment of upper ureteral and renal pelvis stones under spinal anesthesia

“…16 Kozyrakis et al used semirigid URS combined with flexible URS in large upper ureter stone treatment. 17 In our study, the stone-free rate was 72.6% after the first procedure, and the final stone-free rate was 95.2% following additional intervention. Although we have demonstrated that upper ureteral and renal pelvis stones could be successfully treated with semirigid URS, we think that it cannot essentially replace the flexible URS procedure, especially when it comes to the renal pelvis stone treatment issue.…”

The effectiveness of percutaneous nephrolithotomy for the treatment of large impacted upper ureteral stones

“…They reported that,these patients then underwent retrograde endoscopic lithotripsy, which completely cleared the calculi in one session with any complication. In another recent study, Kozyrakis et al reported the effectiveness of retrograde semirigid and flexible ureteroscopic lithotripsy for the treatment of large ureteral stones equal of or greater than 15 mm in 19 patients (21). According to their study, a subsequent RIRS during the same session was necessary in 2 cases.…”

Effect of ultra-mini percutaneous nephrolithotomy and ShuoTong ureteroscopy on the stress response, inflammatory indices, and urokinase level in patients with polycystic kidney disease complicated with renal calculus

“…As a new type of lithotomy in recent years, ShuoTong ureteroscopy is performed with holmium laser lithotripsy through the standard scope and ureteral passage and combined with scabbard in the body. Then the controlled pressure system was used to suction residual lithotripsy to ensure the normal function of the kidney and ureter system, and the residual stone rate was low (7,8). There are limited samples of ultra-mini percutaneous nephrolithotripsy and macroscopical treatment in foreign countries, and there are few studies on polycystic kidney combined with renal stones (9).…”