Fluoroless Ureteroscopy: Experience in More Than 100 Patients
Muhamad Abu Ahmed1, Waslem Abu Nasra1, Ali Safadi1
1Department of Urology, Ziv Medical Center, affiliated with Azrieli Faculty of Medicine in the Galilee, Safed, Israel.
The Israel Medical Association Journal : IMAJ
|January 25, 2022
Summary
Fluoroless ureteroscopy offers a successful alternative for treating select ureteral stones, minimizing radiation exposure. This technique demonstrates a high stone-free rate with minimal adverse events in carefully chosen patients.
Area of Science:
- Endourology
- Urology
- Minimally Invasive Surgery
Background:
- Ureteroscopy is a primary treatment for ureteral stones.
- Fluoroscopy is traditionally used during ureteroscopy.
- Technological advancements question the necessity of fluoroscopy.
Purpose of the Study:
- To evaluate the efficacy of a no-fluoroscopy technique for ureteral stones.
- To summarize experience with fluoroless ureteroscopy in selected patients.
Main Methods:
- Selected patients had 1-2 non-impacted ureteral stones (5-10 mm) with normal contralateral kidney and no infection.
- Procedures utilized rigid scopes, nitinol baskets, and Holmium:YAG laser.
- Stent placement was at the surgeon's discretion.
Main Results:
- 103 patients underwent fluoroless ureteroscopy over 18 months.
- Successful stone removal was achieved in 94 patients.
- Minor complications included ureteral perforations in 5 patients, managed with stenting.
Conclusions:
- Fluoroless ureteroscopy is a highly successful technique for selected ureteral stones.
- This approach can be safely employed with minimal adverse events.
- It represents a viable alternative to traditional fluoroscopy-guided procedures.
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