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Flexible ureteroscopy and laser lithotripsy for single intrarenal stones 2 cm or greater--is this the new frontier?
J Urol. 2008 Mar; 179(3):981-4.JU

Abstract

PURPOSE

Percutaneous nephrolithotomy has been the standard of care for intrarenal calculi greater than 2 cm. Flexible ureteroscopy with holmium laser lithotripsy is a minimally invasive treatment modality that is able to treat large intrarenal calculi with the potential to decrease morbidity, while maintaining a high level of efficacy.

MATERIALS AND METHODS

A total of 15 patients with a single intrarenal calculus 2 cm or greater were treated with retrograde ureteroscopic nephrolithotripsy. Lithotripsy was performed with a 7.2Fr flexible ureteroscope and 200 micron laser fiber. The stone-free rate was defined as the absence of any stones in the kidney or residual stone fragments less than 1 mm, which is too small to be extracted with a basket or a grasper. All patients underwent followup ureteroscopy within 15 days after the last procedure and renal ultrasound 30 days after the last treatment.

RESULTS

There were a total of 15 intrarenal calculi 20 to 25 mm (mean 22) in diameter. The mean number of procedures was 2.3 (range 2 to 4). The overall stone-free rate was 93.3%. One patient (6.6%) had a residual 5 mm stone fragment in the lower pole of the kidney, which was followed expectantly for 2 years with no change in size. There were no major complications. There were 3 minor complications (20%), including 1 emergency room visit for fever and pain, and 2 cases of gross hematuria. All cases were performed on an outpatient basis.

CONCLUSIONS

In select patients with a single intrarenal calculus 2 cm or greater small diameter flexible ureteroscopy with holmium laser lithotripsy may represent an alternative therapy to standard percutaneous nephrolithotomy with acceptable efficacy and low morbidity.

Authors+Show Affiliations

Department of Urology, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18207179

Citation

Breda, Alberto, et al. "Flexible Ureteroscopy and Laser Lithotripsy for Single Intrarenal Stones 2 Cm or Greater--is This the New Frontier?" The Journal of Urology, vol. 179, no. 3, 2008, pp. 981-4.
Breda A, Ogunyemi O, Leppert JT, et al. Flexible ureteroscopy and laser lithotripsy for single intrarenal stones 2 cm or greater--is this the new frontier? J Urol. 2008;179(3):981-4.
Breda, A., Ogunyemi, O., Leppert, J. T., Lam, J. S., & Schulam, P. G. (2008). Flexible ureteroscopy and laser lithotripsy for single intrarenal stones 2 cm or greater--is this the new frontier? The Journal of Urology, 179(3), 981-4. https://doi.org/10.1016/j.juro.2007.10.083
Breda A, et al. Flexible Ureteroscopy and Laser Lithotripsy for Single Intrarenal Stones 2 Cm or Greater--is This the New Frontier. J Urol. 2008;179(3):981-4. PubMed PMID: 18207179.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Flexible ureteroscopy and laser lithotripsy for single intrarenal stones 2 cm or greater--is this the new frontier? AU - Breda,Alberto, AU - Ogunyemi,Oreoluwa, AU - Leppert,John T, AU - Lam,John S, AU - Schulam,Peter G, Y1 - 2008/01/22/ PY - 2007/07/26/received PY - 2008/1/22/pubmed PY - 2008/3/20/medline PY - 2008/1/22/entrez SP - 981 EP - 4 JF - The Journal of urology JO - J. Urol. VL - 179 IS - 3 N2 - PURPOSE: Percutaneous nephrolithotomy has been the standard of care for intrarenal calculi greater than 2 cm. Flexible ureteroscopy with holmium laser lithotripsy is a minimally invasive treatment modality that is able to treat large intrarenal calculi with the potential to decrease morbidity, while maintaining a high level of efficacy. MATERIALS AND METHODS: A total of 15 patients with a single intrarenal calculus 2 cm or greater were treated with retrograde ureteroscopic nephrolithotripsy. Lithotripsy was performed with a 7.2Fr flexible ureteroscope and 200 micron laser fiber. The stone-free rate was defined as the absence of any stones in the kidney or residual stone fragments less than 1 mm, which is too small to be extracted with a basket or a grasper. All patients underwent followup ureteroscopy within 15 days after the last procedure and renal ultrasound 30 days after the last treatment. RESULTS: There were a total of 15 intrarenal calculi 20 to 25 mm (mean 22) in diameter. The mean number of procedures was 2.3 (range 2 to 4). The overall stone-free rate was 93.3%. One patient (6.6%) had a residual 5 mm stone fragment in the lower pole of the kidney, which was followed expectantly for 2 years with no change in size. There were no major complications. There were 3 minor complications (20%), including 1 emergency room visit for fever and pain, and 2 cases of gross hematuria. All cases were performed on an outpatient basis. CONCLUSIONS: In select patients with a single intrarenal calculus 2 cm or greater small diameter flexible ureteroscopy with holmium laser lithotripsy may represent an alternative therapy to standard percutaneous nephrolithotomy with acceptable efficacy and low morbidity. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/18207179/Flexible_ureteroscopy_and_laser_lithotripsy_for_single_intrarenal_stones_2_cm_or_greater__is_this_the_new_frontier L2 - https://www.jurology.com/doi/full/10.1016/j.juro.2007.10.083?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -