Ureteroscopic treatment of larger renal calculi (>2 cm).

Authors

Demetrius H. Bagley, Thomas Jefferson UniversityFollow
Kelly A. Healy, Thomas Jefferson UniversityFollow
Nir Kleinmann, Thomas Jefferson University

Document Type

Article

Publication Date

9-1-2012

Comments

This article has been peer reviewed. It is the author’s final published version in Arab Journal of Urology, Volume 10, Issue 3, September 2012, Pages 296-300.

The published version is available at https://doi.org/10.1016/j.aju.2012.05.005. Copyright © Bagley et al.

Abstract

OBJECTIVES: To evaluate the current status of ureteroscopic lithotripsy (UL) for treating renal calculi of >2 cm, as advances in flexible ureteroscope design, accessory instrumentation and lithotrites have revolutionised the treatment of urinary calculi. While previously reserved for ureteric and small renal calculi, UL has gained an increasing role in the selective management of larger renal stone burdens.

METHODS: We searched the available databases, including PubMed, Google Scholar, and Scopus, for relevant reports in English, and the article bibliographies to identify additional relevant articles. Keywords included ureteroscopy, lithotripsy, renal calculi, and calculi >2 cm. Retrieved articles were reviewed to consider the number of patients, mean stone size, success rates, indications and complications.

RESULTS: In all, nine studies (417 patients) were eligible for inclusion. After one, two or three procedures the mean (range) success rates were 68.2 (23-84)%, 87.1 (79-91)% and 94.4 (90.1-96.7)%, respectively. Overall, the success rate was >90% with a mean of 1.2-2.3 procedures per patient. The overall complication rate was 10.3%, including six (1.4%) intraoperative and 37 (8.9%) postoperative complications, most of which were minor. The most common indications for UL were a failed previous treatment (46%), comorbidities (18.2%), and technical and anatomical factors (12.3%).

CONCLUSIONS: UL is safe and effective for treating large renal calculi. While several procedures might be required for total stone clearance, UL should be considered a standard approach in the urologist's options treating renal calculi of >2 cm.

Recommended Citation

Bagley, Demetrius H.; Healy, Kelly A.; and Kleinmann, Nir, "Ureteroscopic treatment of larger renal calculi (>2 cm)." (2012). Department of Urology Faculty Papers. Paper 45.
https://jdc.jefferson.edu/urologyfp/45

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

PubMed ID

26558040

Language

English