Upper Urinary Tract Stones Managed by Retrograde Intra-Renal Techniques View PDF

^*Safaa Gatea Mezban
Department Of Surgery, Urology And Renal Transplantation Center, Al-Sadder Teaching Hospital, Basrah,, Iraq
Mohammad Fawzi Hamzah Albadran
Department Of Surgery, Urology And Renal Transplantation Center, Al-Sadder Teaching Hospital, Basrah, Iraq
Eman Badr Alfadli
Department Of Surgery, Urology And Renal Transplantation Center, Al-Sadder Teaching Hospital, Basrah, Iraq
Kifah Hassan Jareh
Department Of Surgery, Urology And Renal Transplantation Center, Al-Sadder Teaching Hospital, Basrah, Iraq

^*Corresponding Author:

Safaa Gatea Mezban
Department Of Surgery, Urology And Renal Transplantation Center, Al-Sadder Teaching Hospital, Basrah,, Iraq

Published on: 2025-01-13

Abstract

The evolution of the operative technique makes the flexible ureteroscopy-laser (FLUR-L) an effective and safe method in the treatment of stones of the upper urinary tract (UUT). In this study evaluated the experience on indications the findings and complications of the USSR-L in the treatment of HAU stones. A retrospective concerning 50 patients (19 men and 31 women) over a period of one year (February 2022 to March 2023). The intervention involved 75 kidney stones. For all our patients, a CT urography or/and abdomino-pelvic CT scan was performed to determine the characters of the calculus (size, seat, density, and number). A sterile cyto-bacteriological examination of urine was mandatory. The PUSEN disposable flexible ureteroscope was used. Interventions were done under general anesthesia. Administration of prophylactic anti-biotic with cephalothin. The laser machine used was CALCULASE II SCB KARL STORZ. The main age was 52.54 years; 31 females and 19 males. The etiology of the stones was mostly indeterminate. Indications for the FLUR-L were first- line (68%) of cases followed by failure of renal surgery (28%) and failures of ECL (4%). The criteria for the first-line indication were: patients with blood-clotting disorder/anticoagulant therapy in one patient, lower stone location in 59.4% of cases, single kidney (in 14% of cases) and obesity (BMI > 30 in 80% of cases), computation density well > 1000UH (in 53.62% of cases). The FLUR-L is as effective and safe in the treatment of renal and ureteral stones. It is better the achievement of good results and low morbidity motivates to expand its indications in first intention when the calculus meet the criteria of choice.

Keywords

Stone, Upper urinary tract, Laser lithotripsy, Retrograde intra-renal techniques, Flexible Ureteroscopy-Laser

Introduction

FLUR-L an effective and safe method in the treatment of UUT stones because off the emergence of second generation uretero-scopes and the evolution of the surgical technique. These are depending on several parameters like associated comorbidity conditions, signs and symptoms, location, size, biochemical nature of the stones. FLUR-L notice to be the appropriate treatment for lower calyceal stones inferior to two cm because of the low success rate of the extracorporeal lithotripsy (ECL) [1]. After ECL failure or the persistence of residual fragments after percutaneous nephrolithotomy, the FLUR-L stand out as a saving technique. Its low morbidity urges some urologists to prefer several sessions of USSR-L to an NLPC when the size of the calculus exceeds 20 mm [2]. The disadvantages are high cost and the fragility of the material, a n d l o w accessibility. In this study evaluated the experience on indications the findings and complications of the USSR-L in the treatment of HAU stones.