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Is a contrast study really necessary prior to ureteroscopy?

O Bayrak1, A Demirbas2, O G Doluoglu2

  • 1Department of Urology, School of Medicine, Gazi University, Ankara, Turkey.

Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Medicas E Biologicas
|November 19, 2015
PubMed
Summary

Preoperative imaging for ureteroscopy (laser or other stone removal) showed no significant difference in success or complication rates. Ureteroscopic stone removal is safe and effective without contrast imaging, except for suspected anatomical issues.

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Area of Science:

  • Urology
  • Medical Imaging

Background:

  • Ureteroscopy is a common procedure for removing ureteral stones.
  • Preoperative imaging is crucial for planning ureteroscopic interventions.
  • The impact of different imaging modalities on ureteroscopy outcomes requires further clarification.

Purpose of the Study:

  • To evaluate the influence of various preoperative imaging techniques on the success and complication rates of ureteroscopy for ureteral stone removal.
  • To compare the efficacy and safety of different imaging modalities in guiding ureteroscopic procedures.

Main Methods:

  • Retrospective analysis of 736 patients undergoing rigid ureteroscopy for ureteral stones.
  • Patients were categorized into four groups based on preoperative imaging: intravenous urography, computed tomography, combined computed tomography and intravenous urography, and ultrasonography with abdominal plain film.
  • Comparison of demographics, stone characteristics, operative details, success rates, and intraoperative complication rates across imaging groups.

Main Results:

  • No statistically significant differences were observed in overall success and complication rates among the four imaging groups.
  • Stone-free rates after primary ureteroscopy ranged from 87.1% to 96.7%, with no significant variations between groups (P=0.093).
  • The incidence of intraoperative complications was comparable across all groups (P=0.625), with most being minor (Grade 1 or 2).

Conclusions:

  • Ureteroscopic treatment of ureteral stones can be performed safely and effectively regardless of the preoperative imaging modality used.
  • Contrast study imaging is not essential for ureteroscopy, except in cases with suspected anatomical abnormalities.
  • These findings support the judicious selection of imaging techniques based on clinical necessity rather than routine protocol.