Ureterorenoscopic approach to the symptomatic caliceal diverticulum

Area of Science:

• Urology
• Minimally Invasive Surgery

Background:

• Caliceal diverticula can cause significant patient morbidity, including pain, recurrent infections, and urosepsis.
• Symptomatic caliceal diverticula often require intervention to alleviate symptoms and prevent complications.

Purpose of the Study:

• To evaluate ureterorenoscopy as a treatment for symptomatic caliceal diverticula.
• To assess the efficacy and safety of flexible ureterorenoscopy in managing these conditions.

Main Methods:

• Flexible ureterorenoscopy was used to treat 26 patients (20 women, 6 men) with symptomatic caliceal diverticula.
• Procedures included balloon dilation or incision of the diverticular neck, with intrarenal stone fragmentation when necessary.

Main Results:

• Successful identification and treatment of 16 out of 19 upper/middle caliceal diverticula (84%) and 2 out of 7 lower caliceal diverticula.
• 100% of patients with successfully treated diverticula and fragmented stones were symptom-free at a mean 39-month follow-up.
• Most patients were treated as outpatients or required a single overnight hospital stay, indicating minimal morbidity.

Conclusions:

• Ureterorenoscopy is a highly effective treatment for symptomatic upper and middle caliceal diverticula.
• The procedure offers minimal morbidity and durable symptom relief.
• Flexible ureterorenoscopy provides a valuable minimally invasive option for managing caliceal diverticula.