Introduction Ureteral duplication is the most common ureteral anomaly, occurring in 0.6-0.7% of the population. Our objective was to compare urolithiasis treatment outcomes in patients with and without ureteral duplication. Methods Patients with ureteral duplication who underwent ureteroscopy (URS) were identified in a stone registry at a high volume, tertiary care center from 1998 to 2015. Preoperative, intraoperative, and postoperative data were collected retrospectively. A 1:1 control cohort of patients without duplication was identified, matched by stone location and size, as well as age, BMI and gender. Clinical data and outcomes were compared between duplication and control groups, between partial and complete duplication groups and between patients in whom duplication was identified intraoperatively versus known preoperatively. Results Fifty patients with ureteral duplication who underwent ureteroscopy were identified and were matched to 50 control patients. Patients with ureteral duplication required longer operative time (55 vs 38.5 minutes, p=0.022). Ureteral duplication had no effect on stone-free rates or need for additional procedures. High-grade (Clavien 4-5) complications were similar in both groups (4% vs 4%). Location of ureteral duplication and preoperative knowledge of ureteral duplication did not affect operative time or stone free rates. Conclusions Patients with ureteral duplication undergoing ureteroscopy for urinary stone disease have longer operative times. Preoperative knowledge of ureteral duplication appears to have no significant effect on ureteroscopy's safety or efficacy. In patients without a prior diagnosis of ureteral duplication, our data suggests that intraoperative detection via endoscopy and fluoroscopy are sufficient to safely and completely treat stone disease.
Journal of endourology. 2018 Mar 29 [Epub ahead of print]
Nathan Chertack, Rajat Jain, Manoj Monga, Mark Noble, Sri Sivalingam
Cleveland Clinic Glickman Urological and Kidney Institute, 273142, Department of Urology , 9500 Euclid Ave , Q10-1 , Cleveland, Ohio, United States , 44195-0001., Cleveland Clinic Glickman Urological and Kidney Institute, 273142, Department of Urology, Cleveland, Ohio, United States ; ., Cleveland Clinic Glickman Urological and Kidney Institute, 273142, Department of Urology, Cleveland, Ohio, United States ; ., Cleveland Clinic Glickman Urological and Kidney Institute, 273142, Department of Urology, Cleveland, Ohio, United States ; ., Cleveland Clinic Glickman Urological and Kidney Institute, 273142, Department of Urology, Cleveland, Ohio, United States ; .