The flexible ureterorenoscopy coupled with photovaporisation LASER (USSR-L) for the treatment of kidney kidney is a modern tool whose place is under evaluation.
METHODS: Its place has been assessed in France in 2010 by the Committee of urolithiasis of the French Association of Urology (CLAFU). A practice survey among 27 experts concerned the following decision criteria: comorbid patient's supposed nature of the calculation, anatomy of the urinary tract of the patient. This investigation has been proposed to calculate the size not exceeding 20mm, for a calculation of size greater than 20mm and for multiple calculations kidney.
RESULTS: Fourteen experts responded. The criteria for the USSR-The first line were: morbid obesity (BMI>30), anticoagulation or anti platelet aggregation, calculations Hard (UH>1000, cystine stones), calculations within diverticular caliceal calculations below, the failure of a first treatment or the wish of the patient.
CONCLUSION: The URS-SL was a first-line treatment validated regardless of size and number of kidney stones, when ESWL and PCNL were contraindicated or when their predictable results were poor (hard stones/morbid obesity/lower pole stones) or when stone access is difficult (intradiverticular). It was also the treatment of choice after the failure of a first treatment (ESWL/PCNL).
Written by:
Estrade V, Bensalah K, Bringer JP, Chabannes E, Carpentier X, Conort P, Denis E, Doré B, Gautier JR, Hadjadj H, Hubet J, Hoznek A, Lechevallier E, Meria P, Mozer P, Saussine C, Yonneau L, Traxer O. Are you the author?
Centre Hospitalier d'Angoulême,16959 Angoulême cedex 9, France.
Reference: Prog Urol. 2013 Jan;23(1):22-8.
doi: 10.1016/j.purol.2012.09.003
PubMed Abstract
PMID: 23287480
Article in French.
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