Flexible ureterorenoscopy (URS): technique and results
José Ramón Cansino Alcaide1, Javier Reinoso Elbers, David López Sánchez
1Urology Department, Hospital Universitario La Paz, Madrid, Spain.
Archivos Espanoles De Urologia
|December 29, 2010
Summary
Flexible ureterorenoscopy (Flex URS) effectively treats kidney stones up to 2 cm. This technique achieved a 92.7% stone-free rate three months post-surgery in 100 patients.
Area of Science:
- Urology
- Endourology
- Minimally Invasive Surgery
Background:
- Flexible ureterorenoscopy (Flex URS) adoption has been limited by instrument quality issues.
- Previous ureteroscopes offered poor visibility, illumination, and small working channels, hindering effective use.
Purpose of the Study:
- To detail a specific URS technique employed in the department, highlighting differences from published methods.
- To present the outcomes of 100 consecutive Flex URS procedures for renal lithiasis treatment.
Main Methods:
- A retrospective analysis of 100 patients treated for renal lithiasis between January 2007 and March 2010.
- Utilized Holmium:YAG (Ho:YAG) Laser lithotripsy with 200 and 365 micron fibers.
- Employed ureteroscopic protector sheaths in all cases for 1.5 cm average stone size (range 0.5-6 cm).
Main Results:
- Immediate postoperative stone-free rate (SFR) was 77% (77/100 patients).
- Three-month SFR, confirmed by intravenous urography, reached 92.7% (89/96 patients).
- Complications included 5 ureteral lesions from sheath passage and 9 cases of pain related to double J catheter placement.
Conclusions:
- Flexible URS is a viable treatment option for renal lithiasis in stones up to 2 cm in diameter.
- The presented technique and algorithm support the use of Flex URS for larger stones.
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