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- Title
Complications of 2735 Retrograde Semirigid Ureteroscopy Procedures: A Single-Center Experience.
- Authors
Petrişor Geavlete; Dragoş Georgescu; Gheorghe NiţĂ; Victor Mirciulescu; Victor Cauni
- Abstract
Background and Purpose: Ureteroscopy is nowadays one of the techniques most widely used for upper urinary-tract pathology. Our goal is to describe its complications in a large series of patients.Patients and Methods: Between June 1994 and February 2005, 2436 patients aged 5 to 87 years underwentretrograde ureteroscopy (2735 procedures) under video and fluoroscopic assistance. We used semirigidureteroscopes (8/9.8F Wolf, 6.5F Olympus, 8F and 10F Storz) for 384 diagnostic and 2351 therapeutic procedures.Upper urinary-tract lithiasis (2041 cases), ureteropelvic junction stenosis (95 cases), benign ureteralstenosis (29 cases), tumoral extrinsic ureteral stenosis (84 cases), iatrogenic trauma (35 cases), superficialureteral tumors (16 cases), superficial pelvic tumors (7 cases), and ascending displaced stents (44 cases) werethe indications. The mean follow-up period was 56 months (range 4–112 months).Results: The rate of intraoperative incidents was 5.9% (162 cases). Intraoperative incidents consisted of theimpossibility of accessing calculi (3.7%), trapped stone extractors (0.7%), equipment damage (0.7%), and double-J stent malpositioning (0.76%). In addition, migration of calculi or stone fragments during lithotripsy wasapparent in 116 cases (4.24%). The general rate of intraoperative complications was 3.6% (98 cases). We alsosaw mucosal injury (abrasion [1.5%] or false passage [1%]), ureteral perforation (0.65%), extraureteral stonemigration (0.18%), bleeding (0.1%), and ureteral avulsions (0.11%). Early complications were described in10.64%: fever or sepsis (1.13%), persistent hematuria (2.04%), renal colic (2.23%), migrated double-J stent(0.66%), and transitory vesicoureteral reflux (4.58%, especially in cases with indwelling double-J stents). Wealso found late complications such as ureteral stenosis (3 cases) and persistent vesicoureteral reflux (2 cases).Most (87%) of the complications followed ureteroscopic therapy for stones. Three fourths (76%) of the complicationsoccurred in the first 5 years of the series.Conclusions: According to our experience, mastery of ureteroscopic technique allows the urologist to proceedendourologically with minimum morbidity. Despite the new smaller semirigid instruments, this minimallyinvasive maneuver may sometimes be aggressive, and adequate training is imperative.
- Publication
Journal of Endourology, 2006, Vol 20, Issue 3, p179
- ISSN
0892-7790
- Publication type
Article