Ureteroscopy for symptomatic hydrocalices: a case series.

Hydrocalix remains a rare anatomical variant with limited procedural data. Established treatment involves percutaneous dilation of the stenotic infundibulum. Prior research has shown that percutaneous approaches yield high technical success rates. No prior work had resolved the effectiveness of ureteroscopy for this condition. This gap motivated exploration of less invasive alternatives. Ureteroscopy is known to minimize surgical trauma in similar contexts. However, its role in hydrocalix remains unclear. This paper contributes new procedural data from a small case series.

The aim was to evaluate ureteroscopy as a treatment for hydrocalix. Hydrocalix often causes persistent symptoms despite percutaneous dilation. Ureteroscopy offers a less invasive alternative but lacks sufficient evidence. This study sought to assess both technical and symptomatic outcomes. The specific problem is the lack of procedural success rates for ureteroscopy in this condition. The motivation stems from patient preference for less invasive options. No prior work had resolved the feasibility of ureteroscopic access. This paper contributes to procedural decision-making for urologists.

The study involved 12 retrograde ureteroscopies in 10 patients with hydrocalix. Access was attempted using standard ureteroscopic techniques. Laser, balloon dilation, and cautery were used as dilation methods. Technical success was defined as reaching the hydrocalix. Symptomatic success was tracked through follow-up. Imaging and clinical records were reviewed for outcomes. No prior work had resolved the optimal dilation method. The study focused on procedural outcomes and patient follow-up.

Technical success was achieved in 11 of 12 procedures. One patient could not be accessed retrogradely. Laser dilation was used in eight cases, balloon in two, and cautery in one. Four of seven stone-bearing hydrocalices became stone-free. Six procedures resulted in immediate symptomatic success. Five patients experienced symptom recurrence. Three required additional treatment, including percutaneous approaches. One patient opted against further treatment despite stenosis recurrence.

Ureteroscopy achieved technical success in most patients with hydrocalix. Symptomatic success followed only about half of the procedures. The authors suggest ureteroscopy is a reasonable option for patients seeking less invasive treatment. No prior work had resolved the long-term efficacy of ureteroscopic dilation. The study shows that ureteroscopy does not preclude subsequent percutaneous treatment. The authors propose that ureteroscopy may be suitable for selected patients. The findings suggest that procedural success does not always translate to symptom resolution. The authors emphasize the need for patient-specific procedural planning.