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Ureteroscopic results and complications: experience with 130 cases
G F Daniels1, J E Garnett, M F Carter
1Department of Urology, Northwestern University Medical School, Chicago, Illinois.
The Journal of Urology
|April 1, 1988
Summary
Rigid ureteroscopy for diagnosing urological issues is safe, but treating stones above the pelvic brim increases complication risks. Early procedural experience shows a higher complication rate due to the learning curve.
Area of Science:
- Urology
- Endourology
- Surgical Outcomes
Background:
- Rigid ureteroscopy has evolved for diagnosing and treating urological diseases.
- Understanding factors influencing success and complications is crucial for optimizing patient care.
Purpose of the Study:
- To retrospectively analyze institutional experience with rigid ureteroscopy (1983-1986).
- To identify clinical situations and techniques associated with increased success or complications.
Main Methods:
- Retrospective review of rigid ureteroscopy procedures performed between January 1983 and July 1986.
- Analysis of complication and success rates based on diagnostic versus therapeutic indications, stone location (above vs. below pelvic brim), and experience over time (learning curve).
Main Results:
- Complications were significantly rarer in diagnostic ureteroscopy (6%) compared to procedures for calculi (27%, p < 0.025).
- Ureteroscopy for stones above the pelvic brim had higher failure/complication rates (60%) than for stones below (35%, p < 0.05).
- Major complications were more frequent early in the experience (14% in 1983-1984 vs. 3% in 1985-1986, p < 0.05), indicating a learning curve effect.
Conclusions:
- Diagnostic ureteroscopy carries minimal risk of major complications.
- Avoid ureteroscopy for stones located above the pelvic brim when feasible.
- Higher complication and failure rates are expected early in a surgeon's experience with rigid ureteroscopy.
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