The evolution of ureteroscopy: A modern single-institution series

Amy Krambeck, Francois J. Murat, Matthew T. Gettman, George K. Chow, David E. Patterson, Joseph W. Segura

Research output: Contribution to journalReview article

56 Citations (Scopus)

Abstract

OBJECTIVES: To evaluate a modern ureteroscopy series, including the use of new technological advances, operative procedures, and potential complications, at a single institution and to compare our current experience with our prior published series and the current literature. MATERIAL AND METHODS: We retrospectively reviewed 1000 consecutive ureteroscopies performed in 961 patients from December 1999 to February 2003 at our institution. RESULTS: Semirigid and flexible ureteroscopes were used in 60.3% and 37.0% of the cases, respectively. In 2.6% of cases, a combination of both rigid and flexible ureteroscopes was required. The most common indications for ureteroscopy were as follows: stone, 57.9%; diagnostic, 20.6%; and urothelial carcinoma, 12.6%. Of the stones treated, 31.8% were proximal or middle and 59.1% distal. The overall, proximal, and distal stone-free rates were 91.7%, 87.3%, and 94.2%, respectively. Average operative time was 81 minutes (range, 5-280 minutes). Average follow-up was 2.36 months (range, 1-24 months). The overall complication rate was 1.9% (18/961), including a 0.2% (2/961) incidence of ureteral strictures. CONCLUSION: Current practice trends have shifted to an increased use of flexible ureteroscopes and more frequent ureteroscopic treatment of proximal calculi. Our single treatment stone-free rates are competitive with quoted shock wave lithotripsy success. In addition, there has been a decrease in ureteroscopic-associated complications in our series, with no ureteral avulsions. The improvements in treatment success and decrease in complications may be secondary to advances in ureteroscopic technology.

Original languageEnglish (US)
Pages (from-to)468-473
Number of pages6
JournalMayo Clinic Proceedings
Volume81
Issue number4
DOIs
StatePublished - 2006
Externally publishedYes

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Ureteroscopes
Ureteroscopy
Lithotripsy
Operative Surgical Procedures
Calculi
Operative Time
Pathologic Constriction
Therapeutics
Technology
Carcinoma
Incidence

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Krambeck, A., Murat, F. J., Gettman, M. T., Chow, G. K., Patterson, D. E., & Segura, J. W. (2006). The evolution of ureteroscopy: A modern single-institution series. Mayo Clinic Proceedings, 81(4), 468-473. https://doi.org/10.4065/81.4.468

The evolution of ureteroscopy : A modern single-institution series. / Krambeck, Amy; Murat, Francois J.; Gettman, Matthew T.; Chow, George K.; Patterson, David E.; Segura, Joseph W.

In: Mayo Clinic Proceedings, Vol. 81, No. 4, 2006, p. 468-473.

Research output: Contribution to journalReview article

Krambeck, A, Murat, FJ, Gettman, MT, Chow, GK, Patterson, DE & Segura, JW 2006, 'The evolution of ureteroscopy: A modern single-institution series', Mayo Clinic Proceedings, vol. 81, no. 4, pp. 468-473. https://doi.org/10.4065/81.4.468
Krambeck, Amy ; Murat, Francois J. ; Gettman, Matthew T. ; Chow, George K. ; Patterson, David E. ; Segura, Joseph W. / The evolution of ureteroscopy : A modern single-institution series. In: Mayo Clinic Proceedings. 2006 ; Vol. 81, No. 4. pp. 468-473.
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abstract = "OBJECTIVES: To evaluate a modern ureteroscopy series, including the use of new technological advances, operative procedures, and potential complications, at a single institution and to compare our current experience with our prior published series and the current literature. MATERIAL AND METHODS: We retrospectively reviewed 1000 consecutive ureteroscopies performed in 961 patients from December 1999 to February 2003 at our institution. RESULTS: Semirigid and flexible ureteroscopes were used in 60.3{\%} and 37.0{\%} of the cases, respectively. In 2.6{\%} of cases, a combination of both rigid and flexible ureteroscopes was required. The most common indications for ureteroscopy were as follows: stone, 57.9{\%}; diagnostic, 20.6{\%}; and urothelial carcinoma, 12.6{\%}. Of the stones treated, 31.8{\%} were proximal or middle and 59.1{\%} distal. The overall, proximal, and distal stone-free rates were 91.7{\%}, 87.3{\%}, and 94.2{\%}, respectively. Average operative time was 81 minutes (range, 5-280 minutes). Average follow-up was 2.36 months (range, 1-24 months). The overall complication rate was 1.9{\%} (18/961), including a 0.2{\%} (2/961) incidence of ureteral strictures. CONCLUSION: Current practice trends have shifted to an increased use of flexible ureteroscopes and more frequent ureteroscopic treatment of proximal calculi. Our single treatment stone-free rates are competitive with quoted shock wave lithotripsy success. In addition, there has been a decrease in ureteroscopic-associated complications in our series, with no ureteral avulsions. The improvements in treatment success and decrease in complications may be secondary to advances in ureteroscopic technology.",
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N2 - OBJECTIVES: To evaluate a modern ureteroscopy series, including the use of new technological advances, operative procedures, and potential complications, at a single institution and to compare our current experience with our prior published series and the current literature. MATERIAL AND METHODS: We retrospectively reviewed 1000 consecutive ureteroscopies performed in 961 patients from December 1999 to February 2003 at our institution. RESULTS: Semirigid and flexible ureteroscopes were used in 60.3% and 37.0% of the cases, respectively. In 2.6% of cases, a combination of both rigid and flexible ureteroscopes was required. The most common indications for ureteroscopy were as follows: stone, 57.9%; diagnostic, 20.6%; and urothelial carcinoma, 12.6%. Of the stones treated, 31.8% were proximal or middle and 59.1% distal. The overall, proximal, and distal stone-free rates were 91.7%, 87.3%, and 94.2%, respectively. Average operative time was 81 minutes (range, 5-280 minutes). Average follow-up was 2.36 months (range, 1-24 months). The overall complication rate was 1.9% (18/961), including a 0.2% (2/961) incidence of ureteral strictures. CONCLUSION: Current practice trends have shifted to an increased use of flexible ureteroscopes and more frequent ureteroscopic treatment of proximal calculi. Our single treatment stone-free rates are competitive with quoted shock wave lithotripsy success. In addition, there has been a decrease in ureteroscopic-associated complications in our series, with no ureteral avulsions. The improvements in treatment success and decrease in complications may be secondary to advances in ureteroscopic technology.

AB - OBJECTIVES: To evaluate a modern ureteroscopy series, including the use of new technological advances, operative procedures, and potential complications, at a single institution and to compare our current experience with our prior published series and the current literature. MATERIAL AND METHODS: We retrospectively reviewed 1000 consecutive ureteroscopies performed in 961 patients from December 1999 to February 2003 at our institution. RESULTS: Semirigid and flexible ureteroscopes were used in 60.3% and 37.0% of the cases, respectively. In 2.6% of cases, a combination of both rigid and flexible ureteroscopes was required. The most common indications for ureteroscopy were as follows: stone, 57.9%; diagnostic, 20.6%; and urothelial carcinoma, 12.6%. Of the stones treated, 31.8% were proximal or middle and 59.1% distal. The overall, proximal, and distal stone-free rates were 91.7%, 87.3%, and 94.2%, respectively. Average operative time was 81 minutes (range, 5-280 minutes). Average follow-up was 2.36 months (range, 1-24 months). The overall complication rate was 1.9% (18/961), including a 0.2% (2/961) incidence of ureteral strictures. CONCLUSION: Current practice trends have shifted to an increased use of flexible ureteroscopes and more frequent ureteroscopic treatment of proximal calculi. Our single treatment stone-free rates are competitive with quoted shock wave lithotripsy success. In addition, there has been a decrease in ureteroscopic-associated complications in our series, with no ureteral avulsions. The improvements in treatment success and decrease in complications may be secondary to advances in ureteroscopic technology.

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