TY  - EJOU
AU  - Reed, Amy M. 
AU  - Umbreit, Eric C. 
AU  - Aden, James K. 
AU  - Allam, Christopher L. 

TI  - Semi-rigid ureteroscope as a dilator in renal stone ureteroscopic treatment
T2  - Canadian Journal of Urology

PY  - 2020
VL  - 27
IS  - 4
SN  - 1488-5581

AB  - <b>Introduction:</b> 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.<br/>
<b>Materials and methods:</b> 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.<br/>
<b>Results:</b> 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.<br/>
<b>Conclusion:</b> 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.
KW  - ureteroscopy
KW  -  ureteral dilation
KW  -  kidney stones
KW  -  semi-rigid ureteroscope

DO  -