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Efficacy of flexible ureterorenoscopy with holmium laser in the management of stone-bearing caliceal diverticula.
J Endourol. 2010 Jun; 24(6):961-7.JE

Abstract

PURPOSE

We aim to evaluate the outcome of flexible ureterorenoscopy (F-URS) with a holmium laser in managing stone-bearing caliceal diverticula as a minimally invasive option.

PATIENTS AND METHODS

We retrospectively reviewed the records of 38 patients who underwent F-URS using a holmium laser from 2003 to 2009 for symptomatic stone-bearing caliceal diverticula. The presenting symptoms were renal colic, urinary tract infection, or hematuria. F-URS was used in 30 (78.9%) patients as an alternative after the failure of shockwave lithotropsy (SWL). F-URS was repeated twice for two patients. In the first patient, the indication was uncompleted fragmentation of the stone. In the second patient, it was because of failure to identify the diverticulum. The follow-up visit ranged from 4 to 6 weeks with plain radiography of the kidneys, ureters, and bladder and either renal ultrasonography or noncontrast CT.

RESULTS

Patients who were included in the study were 38: 22 women and 16 men (mean age 45.7 years; range 18-72 years). Post-F-URS, 21 (55.3%) patients were rendered stone free (SF), 10 (26.3%) patients had clinically insignificant residual fragments (less than 4 mm) (CIRF), and a residual fragment (RF) was found in seven (18.4%) patients. The success rate was considered as SF or CIRF, which was obtained in 31 (81.6%) patients. In total, 34 (90%) patients were symptom free after the procedure.

CONCLUSION

F-URS using a holmium laser is a very effective, minimally invasive technique. It could be the best option in managing stone-bearing caliceal diverticula, especially for those patients in whom there was SWL failure. The development of the actively deflectable ureteroscope with miniaturization allowed us to obtain a high success rate, low morbidity, and a brief hospital stay.

Authors+Show Affiliations

Urology Department, Tenon Hospital, Pierre & Marie Curie University, Paris, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20491573

Citation

Sejiny, Majed, et al. "Efficacy of Flexible Ureterorenoscopy With Holmium Laser in the Management of Stone-bearing Caliceal Diverticula." Journal of Endourology, vol. 24, no. 6, 2010, pp. 961-7.
Sejiny M, Al-Qahtani S, Elhaous A, et al. Efficacy of flexible ureterorenoscopy with holmium laser in the management of stone-bearing caliceal diverticula. J Endourol. 2010;24(6):961-7.
Sejiny, M., Al-Qahtani, S., Elhaous, A., Molimard, B., & Traxer, O. (2010). Efficacy of flexible ureterorenoscopy with holmium laser in the management of stone-bearing caliceal diverticula. Journal of Endourology, 24(6), 961-7. https://doi.org/10.1089/end.2009.0437
Sejiny M, et al. Efficacy of Flexible Ureterorenoscopy With Holmium Laser in the Management of Stone-bearing Caliceal Diverticula. J Endourol. 2010;24(6):961-7. PubMed PMID: 20491573.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of flexible ureterorenoscopy with holmium laser in the management of stone-bearing caliceal diverticula. AU - Sejiny,Majed, AU - Al-Qahtani,Saeed, AU - Elhaous,Abdel, AU - Molimard,Benoit, AU - Traxer,Olivier, PY - 2010/5/25/entrez PY - 2010/5/25/pubmed PY - 2010/9/16/medline SP - 961 EP - 7 JF - Journal of endourology JO - J. Endourol. VL - 24 IS - 6 N2 - PURPOSE: We aim to evaluate the outcome of flexible ureterorenoscopy (F-URS) with a holmium laser in managing stone-bearing caliceal diverticula as a minimally invasive option. PATIENTS AND METHODS: We retrospectively reviewed the records of 38 patients who underwent F-URS using a holmium laser from 2003 to 2009 for symptomatic stone-bearing caliceal diverticula. The presenting symptoms were renal colic, urinary tract infection, or hematuria. F-URS was used in 30 (78.9%) patients as an alternative after the failure of shockwave lithotropsy (SWL). F-URS was repeated twice for two patients. In the first patient, the indication was uncompleted fragmentation of the stone. In the second patient, it was because of failure to identify the diverticulum. The follow-up visit ranged from 4 to 6 weeks with plain radiography of the kidneys, ureters, and bladder and either renal ultrasonography or noncontrast CT. RESULTS: Patients who were included in the study were 38: 22 women and 16 men (mean age 45.7 years; range 18-72 years). Post-F-URS, 21 (55.3%) patients were rendered stone free (SF), 10 (26.3%) patients had clinically insignificant residual fragments (less than 4 mm) (CIRF), and a residual fragment (RF) was found in seven (18.4%) patients. The success rate was considered as SF or CIRF, which was obtained in 31 (81.6%) patients. In total, 34 (90%) patients were symptom free after the procedure. CONCLUSION: F-URS using a holmium laser is a very effective, minimally invasive technique. It could be the best option in managing stone-bearing caliceal diverticula, especially for those patients in whom there was SWL failure. The development of the actively deflectable ureteroscope with miniaturization allowed us to obtain a high success rate, low morbidity, and a brief hospital stay. SN - 1557-900X UR - https://www.unboundmedicine.com/medline/citation/20491573/Efficacy_of_flexible_ureterorenoscopy_with_holmium_laser_in_the_management_of_stone_bearing_caliceal_diverticula_ L2 - https://www.liebertpub.com/doi/full/10.1089/end.2009.0437?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -