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Same-Session Bilateral Ureteroscopy: Safety and Outcomes.

Johann P Ingimarsson1, Marcelino Rivera2, John J Knoedler3

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Summary
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Same-session bilateral ureteroscopy for kidney stones is safe and effective, with no long-term complications and high stone-free rates. This procedure offers a viable treatment option for patients with bilateral stone disease.

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Area of Science:

  • Urology
  • Endourology
  • Nephrology

Background:

  • Same-session bilateral ureteroscopy for kidney stones has faced scrutiny due to theoretical risks of bilateral ureteral injury and subsequent renal function impairment.
  • Assessing complications and outcomes is crucial for establishing its safety and efficacy.

Purpose of the Study:

  • To evaluate the safety and outcomes of same-session bilateral ureteroscopy (B URS) in a tertiary referral center.
  • To compare these outcomes with unilateral ureteroscopy (U URS) procedures.

Main Methods:

  • A retrospective review of 117 same-session B URS procedures performed between 2009 and 2014.
  • Comparison with a prospective U URS database.
  • Analysis of short-term and long-term complications, and stone-free rates.

Main Results:

  • 117 same-session B URS procedures were performed in 113 patients.
  • Short-term complications occurred in 16.2% of procedures (Clavien I-III).
  • No long-term complications were observed in patients with 6-week follow-up. Stone-free rates were high (84.2%-91.4%). Complication and readmission rates did not differ significantly from the unilateral group.

Conclusions:

  • Same-session bilateral ureteroscopy is a safe procedure with manageable short-term complications, aligning with existing literature.
  • High stone-free rates and the absence of long-term complications support its use.
  • Bilateral ureteroscopy in a single session is a viable standard of care for managing bilateral kidney stone disease.