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Related Experiment Videos

Routine postoperative imaging is important after ureteroscopic stone manipulation.

Alon Z Weizer1, Brian K Auge, Ari D Silverstein

  • 1Comprehensive Kidney Stone Center, Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.

The Journal of Urology
|June 7, 2002
PubMed
Summary

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Editorial Commentary.

Urology practice·2023
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Editorial Commentary.

Urology practice·2023
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Reply by Authors.

Urology practice·2023

Silent obstruction can occur after ureteroscopy for kidney stones, potentially leading to kidney damage. Routine imaging after ureteroscopic stone treatment is recommended to detect and manage this complication.

Area of Science:

  • Urology
  • Nephrology
  • Medical Imaging

Background:

  • Ureteroscopic procedures for kidney stones have advanced, reducing immediate complications.
  • However, silent obstruction can develop post-procedure, leading to renal damage.
  • Postoperative pain is not a reliable indicator of obstruction.

Purpose of the Study:

  • To determine the incidence of postoperative silent obstruction after ureteroscopy.
  • To assess the necessity of routine functional radiographic studies post-ureteroscopy.

Main Methods:

  • Retrospective review of 459 ureteroscopic procedures for renal or ureteral calculi.
  • Analysis of 241 patients with complete follow-up imaging.
  • Key variables included preoperative/postoperative pain and obstruction.

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Main Results:

  • Silent obstruction occurred in 2.9% of patients (7 out of 241).
  • Obstruction was primarily due to residual stone (83.3%), stricture, or stent issues.
  • Postoperative pain was present in 14% without obstruction, highlighting its unreliability.

Conclusions:

  • Silent obstruction is a significant complication after ureteroscopic stone treatment.
  • Relying solely on pain to guide imaging is risky.
  • Routine imaging (urography, CT, or ultrasound) within 3 months is recommended to prevent renal failure.