Open Access

ARTICLE

Semi-rigid ureteroscope as a dilator in renal stone ureteroscopic treatment

Amy M. Reed¹, Eric C. Umbreit², James K. Aden¹, Christopher L. Allam¹

1 Brooke Army Medical Center, JBSA Fort Sam, Houston, Texas, USA
2 Eglin Hospital, Eglin AFB, Florida, USA
Address correspondence to Dr. Christopher L. Allam, Urology Clinic, Department of Surgery, Brooke Army Medical Center, 3551 Roger Brooke Dr., JBSA Fort Sam Houston, TX 78234 USA

Canadian Journal of Urology 2020, 27(4), 10317-10321.

Abstract

Introduction: To determine the efficacy and safety of using the semi-rigid ureteroscope as the only ureteral dilator for primary ureteroscopy (URS) in the treatment of renal stones.
Materials and methods: A retrospective review of primary URS for renal stone disease was performed on consecutive patients treated by a single provider from 2013 to 2017. Utilizing wire placement under fluoroscopic guidance and direct visual ureteroscopic dilation with a semi-rigid ureteroscope, primary outcome was successful completion of stone treatment. In addition, perioperative safety was evaluated.
Results: A total of 126 consecutive cases of primary URS using the semi-rigid ureteroscope as the only ureteral dilator were attempted for renal stone treatment. The renal stones were treated in 124 (98.4%) patients without other forms of active ureteral dilation. Two (1.6%) patients required ureteral stent placement for passive dilation despite attempted other dilating techniques. No intraoperative ureteral perforations were identified. Postoperative radiographic follow up was available for 67% patients with a 91% stone free rate and no hydronephrosis or ureteral strictures were detected.
Conclusion: Utilizing direct visual semi-rigid ureteroscopic dilation with a semi-rigid ureteroscope prior to flexible ureteroscopy leads to successful primary ureteroscopy for renal stone treatment in most patients. This technique is an effective, safe, and possibly cost-effective method of obtaining ureteral access to facilitate primary URS for renal stone treatment.

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