[Flexible ureteroscopy in the treatment of kidney stone between 2 and 3 cm]

Our aim was to evaluate the outcome of flexible ureteroscopy (F-URS) with Holmium Laser as a minimal invasive procedure for kidney stone between 2 and 3 cm in diameter.

We prospectively evaluated 101 patients (103 kidney units) with kidney stone between 2 and 3 cm, who underwent flexible ureteroscopy (F-URS) with Holmium Laser. Patient age, sex, body mass index (BMI), stone size, stone composition, associated lower calyx stone, prestenting, congenital abnormalities, urological history, operating time and complications were evaluated. The outcome was determined at 4 weeks on plain radiograph (KUB) and noncontrast CT scan (NCCT) or by endoscopic second look if needed. Ureteroscopy success rate was defined as stone free (SF) or remaining fragments (RF) less than 3 mm.

After F-URS session we obtained a stone free status in 35 kidney units (34%), residual fragment less than 3mm in 30 kidney units (29.1%) and 38 kidney units (36.9%) with significant residual fragment. F-URS success rate was 89.3% and 97.1% after second and third session, respectively.

F-URS with Holmium Laser is a very effective and safe technique in treating kidney stone. This technique should be proposed to patient with kidney stone between 2 and 3 cm as one of the treatment modalities, F-URS offers excellent results, low rate of complications and short hospital stay. Patients should be informed about staged therapy.