OBJECTIVE: Flexible ureterorenoscopy (f-URS) for lower pole stones (LPS) compared to other renal locations can be challenging, due to anatomical and technical considerations.
We aimed to compare stone free rate (SFR) and surgical complication rate with f-URS for LPS vs other renal locations.
PATIENTS AND METHODS: We carried out a retrospective, single-centre study including 371 f-URS for renal stone retrieval performed in our institution between January 2004 and December 2010. Among the 371 procedures included in this analysis, 139 were performed for stones located in a single renal location other than the lower pole (Group 1), and 232 for at least one stone located in the lower pole (Group 2). We compared the efficacy (SFR) and the morbidity of f-URS between the 2 groups. The success of the procedure was defined as a complete SFR 6 months after f-URS.
RESULTS: Age, gender, history of urolithiasis, body mass index and pre-operative stenting did not differ between the 2 groups. No differences in stone characteristics were observed between both groups except stone size under 10 mm that was significantly higher in Group 2 (p=0.018). Technical aspects of the procedure did not differ between the groups, except for more frequent use of access sheath in group 2 (p=0.007). SFR was comparable between groups (p=0.774). The complication rate was similar in both groups, as was the severity of complications. By multivariate analysis, stone size >10 mm (p< 0.0001) and multiple stone locations (p=0.001) were associated with f-URS failure, but lower pole location did not impact on SFR.
CONCLUSION: In our study, stone location, in particular LPS, did not have any impact on efficacy and morbidity of f-URS. Only multiple locations and stone size >10 mm seemed to significantly decrease the SFR, without impacting morbidity.
Written by:
Kleinclauss F. Are you the author?
University Hospital of Besancon, Dept of Urology and Renal Transplantation, Besançon, France.
Reference: J Endourol. 2014 May 8. Epub ahead of print.
doi: 10.1089/end.2014.0286
PubMed Abstract
PMID: 24811281
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