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Safety and efficacy of same-session bilateral ureteroscopy
Brent K Hollenbeck1, Timothy G Schuster, Gary J Faerber
1Department of Urology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0330, USA.
Journal of Endourology
|January 28, 2004
Summary
Same-session bilateral ureteroscopy for kidney stones may increase postoperative complications. The overall risk of complications is similar whether procedures are done at once or staged.
Area of Science:
- Urology
- Endourology
- Nephrolithiasis Management
Background:
- Bilateral ureteroscopy for urinary calculi can be performed in one session or staged procedures.
- Same-session procedures may offer cost and anesthetic benefits compared to staged approaches.
Purpose of the Study:
- To evaluate the safety and efficacy of same-session bilateral ureteroscopy.
- Comparison against staged bilateral and multiple unilateral ureteroscopy procedures.
Main Methods:
- Retrospective analysis of 626 ureteroscopy cases (1997-2001).
- Included 34 patients with bilateral calculi (staged vs. same-session) and 54 with multiple unilateral calculi.
- Multivariable regression identified factors associated with postoperative morbidity.
Main Results:
- Similar stone-free rates (50-100%) across groups.
- Higher postoperative complication rate in same-session bilateral ureteroscopy (29%) vs. staged bilateral (14%) and multiple unilateral (11%).
- Same-session bilateral ureteroscopy (OR 4.0) and no postoperative stent (OR 1.7) linked to increased morbidity.
Conclusions:
- Bilateral ureteroscopy increases postoperative morbidity risk.
- Risk is proportional to the number of renal units treated.
- Risk can be incurred at once or over time with staged procedures.