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Evidence for Ureterorenoscopy and Laser Fragmentation (URSL) for Large Renal Stones in the Modern Era

  • Minimally Invasive Surgery (V Bird and M Desai, Section Editors)
  • Published:
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Abstract

Large renal stones (>2 cm) are managed with percutaneous nephrolithotomy (PCNL), which has a good stone-free rate (SFR) but a relatively high incidence of complications graded Clavien ≥3. We wanted to review the literature for the use of ureterorenoscopy and laser fragmentation (URSL) for the management of these stones. A systematic review was done from 1990 to April 2014 for all English language articles reporting on a minimum of 10 patients for stones >2 cm in size (done by 2 reviewers independently) in accordance with the PRISMA and Cochrane review guidelines. A total of 379 articles were identified and after screening for the titles (54) and abstracts (29), 12 papers (651 patients) were included. The male to female ratio was 356:232 with a mean age of 54 years (range 16–86 years). With a mean stone size of 2.7 cm (2–3.15 cm) and the mean operating time of 96 min (28–238 min); the SFR was 91 % (1.45 procedures/patient). The overall number of complications was 58 (8.6 %) of which 26 (4.5 %) were complications classed Clavien ≥3 (haematuria with subcapsular haematoma/clot retention-7; ureteral perforation-7; steinstrasse-5; sepsis/pyelonephritis-5; prostatitis-1; cerebrovascular accident-1). Ureterorenoscopy for large renal stones in the modern era has good SFR with a small risk of major complications.

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Conflict of Interest

Robert Geraghty, Omar Abourmarzouk, Bhavan Rai, Chandra Shakhar Biyani, Nicholas J Rukin and Bhaskar K. Somani each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Urology, University Hospital Southampton NHS Trust, Southampton, SO16 6YD, UK

    Robert Geraghty & Bhaskar K. Somani

  2. University of Wales, Cardiff, UK

    Omar Abourmarzouk

  3. Ninewells Hospital, Dundee, UK

    Bhavan Rai

  4. Pinderfields Hospital, Yorkshire, UK

    Chandra Shakhar Biyani

  5. Wolverhampton Hospital, Wolverhampton, UK

    Nicholas J. Rukin

Authors
  1. Robert Geraghty
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  2. Omar Abourmarzouk
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  3. Bhavan Rai
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  4. Chandra Shakhar Biyani
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  5. Nicholas J. Rukin
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  6. Bhaskar K. Somani
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Correspondence to Bhaskar K. Somani.

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This article is part of the Topical Collection on Minimally Invasive Surgery

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Geraghty, R., Abourmarzouk, O., Rai, B. et al. Evidence for Ureterorenoscopy and Laser Fragmentation (URSL) for Large Renal Stones in the Modern Era. Curr Urol Rep 16, 54 (2015). https://doi.org/10.1007/s11934-015-0529-3

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  • DOI: https://doi.org/10.1007/s11934-015-0529-3

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