INTRODUCTION: The aim of this study was to identify patients not requiring ureteric stone surgery based on pre-operative imaging (within 24 hours) prior to embarking on semirigid ureteroscopy (R-URS) for urolithiasis.
METHODS: The imaging of all consecutive patients on whom R-URS for urolithiasis was performed over a 12-month period was reviewed. All patients had undergone a plain x-ray of the kidney, ureters and bladder (KUB), abdominal non-contrast computed tomography (NCCT-KUB) or both on the day of surgery.
RESULTS: A total of 96 patients were identified for the study. Stone sizes ranged from 3 mm to 20 mm. Thirteen patients (14%) were cancelled as no stone(s) were identified on pre-operative imaging. Of the patients cancelled, 8 (62%) required NCCT-KUB to confirm spontaneous stone passage.
CONCLUSIONS: One in seven patients were stone free on the day of surgery. This negates the need for unnecessary anaesthetic and instrumentation of the urinary tract, with the associated morbidity. Up-to-date imaging prior to embarking on elective ureteric stone surgery is highly recommended.
Written by:
Youssef FR, Wilkinson BA, Hastie KJ, Hall J. Are you the author?
Sheffield Teaching Hospitals NHS Foundation Trust, UK.
Reference: Ann R Coll Surg Engl. 2012 Sep;94(6):428-31.
doi: 10.1308/003588412X13373405385458
PubMed Abstract
PMID: 22943334
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