[Experience in ureteroscopy for managing urolithiasis in one clinic. when does quantity transform into quality?]
V Yu Ivanov1, V A Malkhasyan1, I V Semenyakin1
1Clinic of Urology, A.I. Evdokimov Moscow State University of Medicine and Dentistry, S.I. Spasokukotsky CCH, MHD, Moscow, Russia.
Urologiia (Moscow, Russia : 1999)
|August 29, 2017
Summary
Ureteroscopy effectively treats urinary tract stones, with success rates improving as surgeons gain experience. This minimally invasive procedure is safest and most effective when performed in specialized urology centers.
Area of Science:
- Urology
- Endourology
- Nephrology
Background:
- Ureteroscopy is increasingly utilized for managing urinary tract calculi.
- Surgeon experience and hospital volume impact ureteroscopy outcomes.
- This study evaluates the learning curve of ureteroscopic stone removal.
Purpose of the Study:
- To assess the effectiveness of ureteroscopic stone removal.
- To analyze changes in treatment efficacy and complication rates over time.
- To determine the impact of surgical experience on ureteroscopy outcomes.
Main Methods:
- Analysis of 4031 urolithiasis patients undergoing ureteroscopy (2001-2013).
- Division of the observation period into three distinct phases to track experience gain.
- Evaluation of treatment effectiveness, stone-free rates, and complication incidence.
Main Results:
- Overall stone fragmentation success rate of 95.4%.
- Highest efficacy (96.94%) observed for distal ureteral stones.
- Significant reduction in unsuccessful ureteroscopies (5.7% to 3.5%) and pyelonephritis (15.4% to 2.9%) with increasing experience (p<0.001).
Conclusions:
- Ureteroscopy is a safe and effective treatment for upper urinary tract calculi.
- Effectiveness is highest for distal ureteral stones.
- Specialized urology centers are recommended for performing ureteroscopic interventions due to improved outcomes with experience.
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