Same-Session Bilateral Ureteroscopy

Safety and Outcomes

Johann P. Ingimarsson, Marcelino Rivera, John J. Knoedler, Amy Krambeck

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: To assess the complications and outcomes associated with same-session bilateral ureteroscopy in a tertiary referral center, as same-session bilateral ureteroscopy for stone disease has been critiqued for the theoretical risk of injury to both ureters with subsequent risk to renal function. Methods: We retrospectively reviewed all cases of bilateral ureteroscopy performed for urolithiasis by a single surgeon at out institution between 2009 and 2014. These were compared to a prospective unilateral ureteroscopy database. Results: There were 117 same-session bilateral ureteroscopic procedures performed in 113 patients totaling 234 ureteroscopies. A flexible ureteroscope was used in 228 ureters (97.4%), and 6 (2.6%) were semirigid only. Ureteral dilators were required in 8 (6.8%) cases. Pre-stenting was performed in 23 (19.6%) patients. Short-term complications were observed following 19 (16.2%) procedures, including 11 (9.4%) Clavien I, 4 (3.4%) Clavien II, and 4 (3.4%) Clavien III. Of the 84 (71.8%) patients who completed a 6-week follow-up, there were no long-term complications. Stone-free rates were 91.4% for patients imaged with abdominal x-ray and ultrasound, and 84.2% for those imaged with computed tomography scans. Neither complications nor re-admissions were significantly different in the unilateral group. Median length of follow-up for the entire cohort was 2.8 years (range 0-7 years). Conclusion: Bilateral ureteroscopy can be performed safely with short-term complications, consistent with published literature. We found no long-term complications and high stone-free rates. Bilateral ureteroscopy in a single procedure represents a viable standard of care for patients with bilateral stone disease.

Original languageEnglish (US)
JournalUrology
DOIs
StateAccepted/In press - 2017

Fingerprint

Ureteroscopy
Safety
Ureter
Ureteroscopes
Urolithiasis
Standard of Care
Tertiary Care Centers
Tomography
X-Rays
Databases
Kidney
Wounds and Injuries

ASJC Scopus subject areas

  • Urology

Cite this

Same-Session Bilateral Ureteroscopy : Safety and Outcomes. / Ingimarsson, Johann P.; Rivera, Marcelino; Knoedler, John J.; Krambeck, Amy.

In: Urology, 2017.

Research output: Contribution to journalArticle

Ingimarsson, Johann P. ; Rivera, Marcelino ; Knoedler, John J. ; Krambeck, Amy. / Same-Session Bilateral Ureteroscopy : Safety and Outcomes. In: Urology. 2017.
@article{9253cd4238764895a82215bc8c18432d,
title = "Same-Session Bilateral Ureteroscopy: Safety and Outcomes",
abstract = "Objective: To assess the complications and outcomes associated with same-session bilateral ureteroscopy in a tertiary referral center, as same-session bilateral ureteroscopy for stone disease has been critiqued for the theoretical risk of injury to both ureters with subsequent risk to renal function. Methods: We retrospectively reviewed all cases of bilateral ureteroscopy performed for urolithiasis by a single surgeon at out institution between 2009 and 2014. These were compared to a prospective unilateral ureteroscopy database. Results: There were 117 same-session bilateral ureteroscopic procedures performed in 113 patients totaling 234 ureteroscopies. A flexible ureteroscope was used in 228 ureters (97.4{\%}), and 6 (2.6{\%}) were semirigid only. Ureteral dilators were required in 8 (6.8{\%}) cases. Pre-stenting was performed in 23 (19.6{\%}) patients. Short-term complications were observed following 19 (16.2{\%}) procedures, including 11 (9.4{\%}) Clavien I, 4 (3.4{\%}) Clavien II, and 4 (3.4{\%}) Clavien III. Of the 84 (71.8{\%}) patients who completed a 6-week follow-up, there were no long-term complications. Stone-free rates were 91.4{\%} for patients imaged with abdominal x-ray and ultrasound, and 84.2{\%} for those imaged with computed tomography scans. Neither complications nor re-admissions were significantly different in the unilateral group. Median length of follow-up for the entire cohort was 2.8 years (range 0-7 years). Conclusion: Bilateral ureteroscopy can be performed safely with short-term complications, consistent with published literature. We found no long-term complications and high stone-free rates. Bilateral ureteroscopy in a single procedure represents a viable standard of care for patients with bilateral stone disease.",
author = "Ingimarsson, {Johann P.} and Marcelino Rivera and Knoedler, {John J.} and Amy Krambeck",
year = "2017",
doi = "10.1016/j.urology.2017.06.027",
language = "English (US)",
journal = "Urology",
issn = "0090-4295",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Same-Session Bilateral Ureteroscopy

T2 - Safety and Outcomes

AU - Ingimarsson, Johann P.

AU - Rivera, Marcelino

AU - Knoedler, John J.

AU - Krambeck, Amy

PY - 2017

Y1 - 2017

N2 - Objective: To assess the complications and outcomes associated with same-session bilateral ureteroscopy in a tertiary referral center, as same-session bilateral ureteroscopy for stone disease has been critiqued for the theoretical risk of injury to both ureters with subsequent risk to renal function. Methods: We retrospectively reviewed all cases of bilateral ureteroscopy performed for urolithiasis by a single surgeon at out institution between 2009 and 2014. These were compared to a prospective unilateral ureteroscopy database. Results: There were 117 same-session bilateral ureteroscopic procedures performed in 113 patients totaling 234 ureteroscopies. A flexible ureteroscope was used in 228 ureters (97.4%), and 6 (2.6%) were semirigid only. Ureteral dilators were required in 8 (6.8%) cases. Pre-stenting was performed in 23 (19.6%) patients. Short-term complications were observed following 19 (16.2%) procedures, including 11 (9.4%) Clavien I, 4 (3.4%) Clavien II, and 4 (3.4%) Clavien III. Of the 84 (71.8%) patients who completed a 6-week follow-up, there were no long-term complications. Stone-free rates were 91.4% for patients imaged with abdominal x-ray and ultrasound, and 84.2% for those imaged with computed tomography scans. Neither complications nor re-admissions were significantly different in the unilateral group. Median length of follow-up for the entire cohort was 2.8 years (range 0-7 years). Conclusion: Bilateral ureteroscopy can be performed safely with short-term complications, consistent with published literature. We found no long-term complications and high stone-free rates. Bilateral ureteroscopy in a single procedure represents a viable standard of care for patients with bilateral stone disease.

AB - Objective: To assess the complications and outcomes associated with same-session bilateral ureteroscopy in a tertiary referral center, as same-session bilateral ureteroscopy for stone disease has been critiqued for the theoretical risk of injury to both ureters with subsequent risk to renal function. Methods: We retrospectively reviewed all cases of bilateral ureteroscopy performed for urolithiasis by a single surgeon at out institution between 2009 and 2014. These were compared to a prospective unilateral ureteroscopy database. Results: There were 117 same-session bilateral ureteroscopic procedures performed in 113 patients totaling 234 ureteroscopies. A flexible ureteroscope was used in 228 ureters (97.4%), and 6 (2.6%) were semirigid only. Ureteral dilators were required in 8 (6.8%) cases. Pre-stenting was performed in 23 (19.6%) patients. Short-term complications were observed following 19 (16.2%) procedures, including 11 (9.4%) Clavien I, 4 (3.4%) Clavien II, and 4 (3.4%) Clavien III. Of the 84 (71.8%) patients who completed a 6-week follow-up, there were no long-term complications. Stone-free rates were 91.4% for patients imaged with abdominal x-ray and ultrasound, and 84.2% for those imaged with computed tomography scans. Neither complications nor re-admissions were significantly different in the unilateral group. Median length of follow-up for the entire cohort was 2.8 years (range 0-7 years). Conclusion: Bilateral ureteroscopy can be performed safely with short-term complications, consistent with published literature. We found no long-term complications and high stone-free rates. Bilateral ureteroscopy in a single procedure represents a viable standard of care for patients with bilateral stone disease.

UR - http://www.scopus.com/inward/record.url?scp=85026317262&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85026317262&partnerID=8YFLogxK

U2 - 10.1016/j.urology.2017.06.027

DO - 10.1016/j.urology.2017.06.027

M3 - Article

JO - Urology

JF - Urology

SN - 0090-4295

ER -