PURPOSE: To determine the efficacy and safety of flexible ureterorenoscopy (fURS) for the treatment of single intrarenal calculi and further stratify the efficacy by stone burden.
MATERIAL AND METHODS: CROES collected prospective data on consecutive patients with urinary stones treated with URS at 114 centers worldwide for 1 year. Only patients who underwent fURS for a solitary renal stone where included in the present study. Pre- and intraoperative characteristics, and post- operative outcomes were evaluated. The relationships between stone size and stone-free rate (SFR), operative time, complications, hospital stay, and need for retreatment were explored.
RESULTS AND LIMITATIONS: A total of 1210 patients with solitary kidney stones < 10mm (52.2%), 10-20mm (43.2%) and >20mm (4.6%) were treated with fURS. There was a negative correlation between SFR and stone size when adjusted for BMI. Operating time showed a positive correlation with stone size when adjusted for BMI. Single session SFR was 90% for stones < 10mm and 80% for stones < 15 mm. Patients with stones >20mm achieved a 30% SFR, more often needed retreatment and were more often readmitted. There were no differences in overall complication rates for different stone sizes. However, patients with a stone >20mm had a higher probability of developing fever after fURS as compared to patients with smaller stones.
CONCLUSIONS: Our data indicate that fURS for a single intrarenal stone is a safe procedure. Best results after single session fURS were obtained for stones < 15mm.
Written by:
Skolarikos A, Gross AJ, Krebs A, Unal D, Bercowsky E, Eltahawy E, Somani B, Rosette J. Are you the author?
Department of Urology, Sismanoglio Hospital, Athens; Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany; Department of Urology, Clinica Alemana de Santiago, Chile; Department of Urology, School of Medicine, Hacettepe University, Ankara, Turkey; Department of Urology, Hospital Mateu Orfila, Menorca, Spain; Department of Urology, University of Arkansas for Medical Sciences,Little Rock, USA; Department of Urology, Ain Shams University, Egypt; Department of Urology, University Hospital Southampton NHS Trust, United Kingdom; Department of Urology, AMC University Medical Centre, Amsterdam, the Netherlands.
Reference: J Urol. 2015 Feb 9. pii: S0022-5347(15)00252-9.
doi: 10.1016/j.juro.2015.01.112
PubMed Abstract
PMID: 25676432