Open Access

HOW I DO IT

The prone ureteroscopic technique for managing large stone burdens

Kevan M. Sternberg¹, Bruce L. Jacobs², Benjamin J. King¹, Jared B. Wachterman¹, Khaled Shahrour², Katherine M. Theisen², Sarah E. Sprauer², Erin Ohmann², Timothy D. Averch²

1 Department of Surgery, Division of Urology, University of Vermont, Burlington, Vermont, USA
2 Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. USA
Address correspondence to Dr. Kevan M. Sternberg, Division of Urology, University of Vermont College of Medicine, Fletcher House 301, 111 Colchester Avenue, Burlington VT 05401 USA

Canadian Journal of Urology 2015, 22(2), 7758-7762.

Abstract

Percutaneous nephrolithotomy (PCNL) is the standard treatment for patients with large stone burdens, but can be associated with significant complications. Flexible ureteroscopy is an alternative approach that is less invasive, but often requires multiple procedures. Typically, many factors play a role in the decision to perform PCNL or ureteroscopy. The challenge is that it is difficult to predict which stone burdens will be able to be cleared ureteroscopically. We describe our approach using initial prone ureteroscopy with the transition to standard prone PCNL if required.

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