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Aim: Advances in the technology of ureteroscopes and lithotriptors have led to the implementation of retrograde intrarenal surgery (RIRS) in the treatment of renal Stones. This study aimed to compare the outcomes and complications of semirigid ureterorenoscopy (s-URS) and percutaneous nephrolithotomy (PCNL) for the treatment of renal pelvic stones larger than 2 cm, retrospectively.  Material and Method: Between January 2014 and July 2016, 90 patients with single renal pelvic stones of more than 2 cm were treated by PCNL (group 1) or s-URS (group 2). Group 1 had 44; group 2 had 46 patients. Demographic features of patients such as age, gender, body mass index (BMI) as well as stone size were compared. Perioperative course and postoperative outcomes such as stone-free and complication rates were also evaluated. Patients assessed by plain abdominal radiography 24 hours after surgery and non-contrast computed tomography at 3rd months, postoperatively. Clinical success was defined as stone-free status.  Results: Mean ages of patients in group 1 and 2 were 40.29±19.78 and 38.41±23.26 year, respectively (p=0.681). Two groups were comparable in terms of gender, BMI, grade of hydronephrosis. Mean stone sizes were also similar. The mean operation, fluoroscopy and hospitalization times were shorter in group 2. After first sessions, mean stone-free rates for PCNL and s-URS were 81.8% and 60.8%, respectively (p=0.037). In the s-URS group,11 patients underwent f-URS due to stone migration into lower calix, and 7 of them became stone-free after those procedures. At 3rd months follow-up, those rates were determined as 84.1% and 76%, respectively.  Discussion: Although s-URS is not superior to PCNL in the treatment of large renal pelvic stones, it can be used to reach renal pelvis and fragment those stones in selected cases.

Aim: Advances in the technology of ureteroscopes and lithotriptors have led to the implementation of retrograde intrarenal surgery (RIRS) in the treatment of renal Stones. This study aimed to compare the outcomes and complications of semirigid ureterorenoscopy (s-URS) and percutaneous nephrolithotomy (PCNL) for the treatment of renal pelvic stones larger than 2 cm, retrospectively.  Material and Method: Between January 2014 and July 2016, 90 patients with single renal pelvic stones of more than 2 cm were treated by PCNL (group 1) or s-URS (group 2). Group 1 had 44; group 2 had 46 patients. Demographic features of patients such as age, gender, body mass index (BMI) as well as stone size were compared. Perioperative course and postoperative outcomes such as stone-free and complication rates were also evaluated. Patients assessed by plain abdominal radiography 24 hours after surgery and non-contrast computed tomography at 3rd months, postoperatively. Clinical success was defined as stone-free status.  Results: Mean ages of patients in group 1 and 2 were 40.29±19.78 and 38.41±23.26 year, respectively (p=0.681). Two groups were comparable in terms of gender, BMI, grade of hydronephrosis. Mean stone sizes were also similar. The mean operation, fluoroscopy and hospitalization times were shorter in group 2. After first sessions, mean stone-free rates for PCNL and s-URS were 81.8% and 60.8%, respectively (p=0.037). In the s-URS group,11 patients underwent f-URS due to stone migration into lower calix, and 7 of them became stone-free after those procedures. At 3rd months follow-up, those rates were determined as 84.1% and 76%, respectively.  Discussion: Although s-URS is not superior to PCNL in the treatment of large renal pelvic stones, it can be used to reach renal pelvis and fragment those stones in selected cases.

Kidney stone disease is a common condition that can cause pain, infection and longterm renal impairment if not treated. Ureteroscopy is commonly used to treat urinary tract calcluli with the use of laser lithotripsy of stones.Although ureteroscopy has a strong body of evidence and is supported by international guidelines infectious complications can commonly occur postoperatively and these can potentially have severe consequences. The purpose of this systematic review is the identify the incidence of infective complications post-ureteroscopy for stone disease and any predictors of infection.

This article is from Journal of Indian Association of Pediatric Surgeons , volume 19 . Abstract Aim:: To report our experience of Pediatric ureterorenoscopy for ureteric calculi from two tertiary Pediatric urology centers at Apollo Children's Hospital, Chennai and Indraprastha Apollo Hospital, New Delhi. Material and methods:: All children who presented with symptomatic ureteric stones greater than 6 mm were entered into the study. All children less than 12 months and more than 18 years of age and those who underwent ureterorenoscopy for indications other than the stones were excluded from the study. The children were managed on a fixed investigative and treatment protocol. The data from the Apollo Hospital New Delhi and Apollo Children's Hospital Chennai was analysed. Results:: There were a total of thirty eight children, twenty in Chennai and eighteen in the New Delhi study. The mean age was 10.4 years and 8.5 years and the youngest child was14 months and 24 months in the Chennai and New Delhi group respectively. There was one conversion to open surgery in either group. Pneumatic lithotripter was used in majority of cases and holmium laser in select children. Conclusion:: This is the largest Indian series of ureterorenoscopy for ureteric calculi in children. This study over nearly a decade confirms the safety and efficacy of this technique even in young children. In children less than five years, prestenting and delayed ureterorenoscopy allows safe endoscopic treatment of ureteric calculi.

We aim to evaluate the economic impact of ureteroscopy (URS) and shockwave lithotripsy (SWL) for treatment of urolithiasis in adult patients, revealing cost-effectiveness of the two procedures. We also want to evaluate the possible influence of preoperative, intraoperative and postoperative (complications, retreatments) on related costs.

This article is from Journal of Medical Case Reports , volume 6 . Abstract Introduction: We previously reported on the effectiveness of ureteroscopy-assisted retrograde nephrostomy during percutaneous nephrolithotomy and report two cases of lower calyx calculi in horseshoe kidney that were successfully treated with ureteroscopy-assisted retrograde nephrostomy. During the ureteroscopy-assisted retrograde nephrostomy procedure, a ureteroscope is advanced in the desired calyx and a Lawson retrograde nephrostomy puncture wire is inserted. The wire is advanced through the calyx to exit the skin. The wire is then used for the percutaneous dilation. Case presentation: Case 1 was a 68-year-old man who was shown on radiography to have left lower calyx calculi (19 × 15mm, 7 × 5mm, and 7 × 3mm) in horseshoe kidney. Case 2 was a 36-year-old woman shown on radiography to have a left lower calyx calculus (10 × 8mm) in horseshoe kidney. Conclusions: Both patients were stone-free after ureteroscopy-assisted retrograde nephrostomy during percutaneous nephrolithotomy. Ureteroscopy-assisted retrograde nephrostomy is a promising procedure for safely and effectively treating lower calyx stones in horseshoe kidney.

Ureteroscopy (URS) is widely used in management of kidney stone disease (KSD). The aim of this study was to ascertain the mortality associated with ureteroscopy (URS) in the management of kidney stone disease (KSD), with a focus to identify relevant risk factors and highlight key learning points to prevent and reduce mortality from URS.

Ureteroscopy (URS) is widely used in management of kidney stone disease (KSD). The aim of this study was to ascertain the mortality associated with ureteroscopy (URS) in the management of kidney stone disease (KSD), with a focus to identify relevant risk factors and highlight key learning points to prevent and reduce mortality from URS.

This article is from Central European Journal of Urology , volume 65 . Abstract Introduction: We present our experience with the use of semirigid ureteroscopy for the treatment of ureteric stones in children less than or equal to 6 years of age. Material and methods: The records of 21 children (12 female, 9 male) with an average age of 4.7 years (range 8 months to 6 years) treated with semirigid ureteroscopy between June 2006 and July 2010 were reviewed. In 13 ureteral units 7Fr semirigid ureteroscopy was carried out in a retrograde manner to treat stone disease, while an adult ureteroscope (9.5 fr) was used in the remaining patients. Stones were located in the upper ureter in 2 cases, middle ureter in 2 cases, and lower ureter in 17 cases. Ureteral dilation was not required in all patients. Results: Stone size varied from 4 to 13 mm (mean 6 mm). The management of stones in 18 (90.7%) children was straightforward and a single ureteroscopy was required to clear the ureters. In 2 (6.2%) children, repeat ureteroscopy was undertaken to render the ureters stone free, and in 1 child (3.1%) it was not possible to remove the stone. Stones were fragmented with pneumatic lithotripsy in 12 cases and stones were removed mechanically without fragmentation in the remaining 9 cases. Intraoperative complications occurred in 2 (9.3%) children and included extravasation (1 patient), which was managed with ureteral stenting and stone upward migration (1 patient). Early postoperative complications included pyelonephritis (1 patient). Mean follow-up was 6.4 (3-36) months. Incidence of stricture at the site of stone impaction was not detected in any patients. None of the patients managed without a post-operative stent required subsequent intervention. Conclusions: In the hands of an experienced surgeon, ureteroscopy in young children can be a safe and efficient treatment for ureteral stones that can be performed without ureteral dilation. Routine ureteral stenting is not a requirement when the procedure is relatively atraumatic. Further studies and longer follow-up are necessary to determine the success of this technique.

This article is from Indian Journal of Urology : IJU : Journal of the Urological Society of India , volume 28 . Abstract Obesity is associated with increased surgical morbidity and mortality. We previously reported on the usefulness of ureteroscopy assisted retrograde nephrostomy (UARN) and here we report a case of renal calculi successfully treated with UARN during percutaneous nephrolithotomy (PCNL) in an obese patient. A 63-year-old female with left renal calculi was referred to Department of Urology, Ohguchi Higashi General Hospital. Her body mass index was 34.0 kg/m2. Stone fragments were completely extracted. URS-assisted puncture from the renal collecting system to the skin under fluoroscopic guidance was a safe and easy procedure in our obese patient.

This article is from Korean Journal of Urology , volume 54 . Abstract Purpose: Preoperative percutaneous nephrostomy (PCN) can be applied to urinary stone patients with pyelonephritis as well as obstructive uropathy; thus, some patients undergo flexible ureteroscopy (fURS) in the presence of a PCN tube. We evaluated the effectiveness of PCN during fURS for the management of renal stones. Materials and Methods: We retrospectively analyzed 130 consecutive patients who underwent fURS for renal stones between January 2009 and December 2011. All fURS procedures were performed by a single experienced surgeon. The patients were divided into two groups depending on the presence of PCN during the surgery: patients with PCN (group 1, n=41) and patients without PCN (group 2, n=89). To evaluate operative outcomes, we compared success rates, operative times, and complication rates. We defined success as the absence of any residual stones in the kidney or stone fragments less than 2 mm that were too small to be extracted during follow-up. Results: There were no significant differences in age, sex, body mass index, stone laterality, burden, or location between the two groups. The mean operative times of groups 1 and 2 were 50.1 and 58.3 minutes, respectively (p=0.102). The success rates of groups 1 and 2 were 95.1% and 82.0%, respectively (p=0.044). There was no statistically significant difference in the complication rate between groups 1 and 2 (p=0.888). Conclusions: Flexible ureteroscopy in the presence of PCN produced a superior outcome in terms of the success rate without increasing the operative time or complication rate. PCN may be helpful to induce better outcomes of fURS.

This article is from Case Reports in Nephrology and Urology , volume 2 . Abstract A 33-year-old male with an ileal conduit was referred to our department for the treatment of left renal calculi. After inserting a ureteral access sheath, a ureteroscopy-assisted retrograde nephrostomy was made. Percutaneous nephrolithotomy was successfully achieved using this nephrostomy.