Emergency vs elective ureteroscopy for a single ureteric stone

Area of Science:

• Urology
• Endourology
• Nephrolithiasis Management

Background:

• Ureteric stones are a common cause of acute abdominal pain.
• Ureteroscopy (URS) is a primary treatment modality for ureteric stones.
• The optimal timing for URS (emergency vs. elective) remains a subject of investigation.

Purpose of the Study:

• To compare the safety and efficacy of emergency ureteroscopy (EM URS) versus elective ureteroscopy (EL URS) for treating single ureteric stones.
• To evaluate complication rates and stone-free rates between the two treatment groups.

Main Methods:

• Retrospective review of adult patients with single ureteric stones undergoing URS.
• Patients were divided into an emergency group (URS within 24 hours for persistent renal colic) and an elective group (URS after ≥14 days).
• Exclusion criteria included fever, turbid urine, and ureteric stenting prior to URS.

Main Results:

• 179 patients were included (107 EM, 72 EL).
• Complication rates were comparable (5.6% EM vs. 4.2% EL, P=0.665).
• Stone-free rates were also comparable (96% EM vs. 93% EL, P=0.336).

Conclusions:

• Emergency URS is a safe and effective treatment option for single ureteric stones when performed in patients without signs of infection.
• The study supports the use of emergency URS in select cases, demonstrating comparable outcomes to elective procedures.
• Careful patient selection is crucial for optimizing outcomes in emergency ureteroscopy for ureteric stones.