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Urologic Endoscopic Procedure: Cystoscopic Examination01:28

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
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The ureters are retroperitoneal tubes located on either side of the vertebral column. They are responsible for transporting urine from each kidney to the urinary bladder. These tubes have thick walls and are approximately 25-30 cm long. Their diameter is around 10 mm at the renal pelvis, gradually narrowing to 1 mm as the ureter obliquely enters the posterior bladder wall through the ureteric orifices. The shape of these orifices is slit-like, which helps to prevent urine backflow toward the...
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Kidney, Ureter, and Bladder (KUB) StudiesKidney, Ureter, and Bladder (KUB) studies are standard diagnostic imaging procedures used to assess the anatomy of the urinary system. They are commonly utilized for patients experiencing abdominal pain or urinary symptoms. By using a simple X-ray of the abdomen, KUB studies can reveal structural and pathological abnormalities within the kidneys, ureters, and bladder. These studies are particularly valuable in diagnosing kidney stones, urinary...
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Imaging Studies II: Ultrasonography01:24

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IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
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Current Standard Technique for Modern Flexible Ureteroscopy: Tips and Tricks.

Guido Giusti1, Silvia Proietti2, Luca Villa3

  • 1Urology Department, IRCCS San Raffaele Scientific Institute, Ville Turro Division, Milan, Italy.

European Urology
|April 19, 2016
PubMed
Summary

Flexible ureteroscopy (fURS) offers a safe and effective treatment for kidney stones, achieving high stone-free rates. Larger stones may require multiple treatment sessions for complete clearance.

Keywords:
ComplicationsFlexible ureteroscopyRenal stonesStone-free rateSurgical techniqueTips and tricks

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Area of Science:

  • Urology
  • Endourology
  • Minimally Invasive Surgery

Background:

  • Flexible ureteroscopy (fURS) is increasingly utilized for renal stone treatment due to advancements in endoscopic technology.
  • This technique offers high stone-free rates and low morbidity compared to traditional methods.

Purpose of the Study:

  • To detail the step-by-step surgical technique for fURS in treating renal stones.
  • To evaluate the effectiveness and safety of this standardized fURS procedure.

Main Methods:

  • Retrospective analysis of 316 consecutive patients undergoing fURS for renal stones.
  • Standardized ureteroscopy and laser lithotripsy using modern flexible ureteroscopes were employed.

Main Results:

  • The overall primary stone-free rate was 79.1%, reaching 91.5% after tertiary procedures.
  • Complications occurred in 29.1% of patients, predominantly low-grade (Clavien 1-2).
  • Mean operative time was 72.6 minutes, with an average of 1.27 procedures per patient.

Conclusions:

  • Flexible ureteroscopy is a safe and effective modality for managing renal stones.
  • Staged procedures are often necessary for achieving complete stone clearance in patients with large calculi.