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Retrograde ureteroscopy for renal stones larger than 2.5 cm.
J Endourol. 2009 Sep; 23(9):1395-8.JE

Abstract

INTRODUCTION AND OBJECTIVES

Because of the advances in endoscopic technology, retrograde flexible ureteroscopy (URS) is being applied to larger renal stone burdens. For stones greater than 2.5 cm, percutaneous nephrolithotomy has long been considered the standard of care. We have encountered a growing population of patients who desire a less invasive, less disruptive approach to large renal stones. We present our experience with retrograde ureteroscopic management of renal stones larger than 2.5 cm.

METHODS

Twenty-two patients between October 2004 and June 2008 underwent retrograde flexible URS with holmium laser lithotripsy. Each patient underwent retrograde URS using the Storz Flex-X and a ureteral access sheath. Patients were evaluated for number of procedures, stone clearance rates, and hospital admissions. Postoperative kidney, ureter, and bladder radiograph was used to determine stone-free rates.

RESULTS

Mean stone size was 3.0 cm. The average number of procedures was 1.82 with 5 patients requiring one, 14 requiring two, and 1 requiring three procedures. There were two failures who went on to have percutaneous nephrolithotomy, both of whom had significant lower pole stone burden. Overall stone-free rate was 90.9%. There were three overnight admissions for stent pain, and one 3-day admission for bacteremia in a patient who was noncompliant with preoperative antibiotics.

CONCLUSIONS

Planned staged URS is a viable option for the treatment of renal stones larger than 2.5 cm with excellent stone-free results. Significant lower pole stone burden is a limiting factor.

Authors+Show Affiliations

Department of Urology, University of Missouri, Columbia, Missouri, USA. rileyju@health.missouri.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

19694527

Citation

Riley, Julie M., et al. "Retrograde Ureteroscopy for Renal Stones Larger Than 2.5 Cm." Journal of Endourology, vol. 23, no. 9, 2009, pp. 1395-8.
Riley JM, Stearman L, Troxel S. Retrograde ureteroscopy for renal stones larger than 2.5 cm. J Endourol. 2009;23(9):1395-8.
Riley, J. M., Stearman, L., & Troxel, S. (2009). Retrograde ureteroscopy for renal stones larger than 2.5 cm. Journal of Endourology, 23(9), 1395-8. https://doi.org/10.1089/end.2009.0391
Riley JM, Stearman L, Troxel S. Retrograde Ureteroscopy for Renal Stones Larger Than 2.5 Cm. J Endourol. 2009;23(9):1395-8. PubMed PMID: 19694527.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Retrograde ureteroscopy for renal stones larger than 2.5 cm. AU - Riley,Julie M, AU - Stearman,Laura, AU - Troxel,Scott, PY - 2009/8/22/entrez PY - 2009/8/22/pubmed PY - 2009/11/13/medline SP - 1395 EP - 8 JF - Journal of endourology JO - J Endourol VL - 23 IS - 9 N2 - INTRODUCTION AND OBJECTIVES: Because of the advances in endoscopic technology, retrograde flexible ureteroscopy (URS) is being applied to larger renal stone burdens. For stones greater than 2.5 cm, percutaneous nephrolithotomy has long been considered the standard of care. We have encountered a growing population of patients who desire a less invasive, less disruptive approach to large renal stones. We present our experience with retrograde ureteroscopic management of renal stones larger than 2.5 cm. METHODS: Twenty-two patients between October 2004 and June 2008 underwent retrograde flexible URS with holmium laser lithotripsy. Each patient underwent retrograde URS using the Storz Flex-X and a ureteral access sheath. Patients were evaluated for number of procedures, stone clearance rates, and hospital admissions. Postoperative kidney, ureter, and bladder radiograph was used to determine stone-free rates. RESULTS: Mean stone size was 3.0 cm. The average number of procedures was 1.82 with 5 patients requiring one, 14 requiring two, and 1 requiring three procedures. There were two failures who went on to have percutaneous nephrolithotomy, both of whom had significant lower pole stone burden. Overall stone-free rate was 90.9%. There were three overnight admissions for stent pain, and one 3-day admission for bacteremia in a patient who was noncompliant with preoperative antibiotics. CONCLUSIONS: Planned staged URS is a viable option for the treatment of renal stones larger than 2.5 cm with excellent stone-free results. Significant lower pole stone burden is a limiting factor. SN - 1557-900X UR - https://www.unboundmedicine.com/medline/citation/19694527/Retrograde_ureteroscopy_for_renal_stones_larger_than_2_5_cm_ L2 - https://www.liebertpub.com/doi/10.1089/end.2009.0391?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -