We aimed at comparing the success and complications of early semirigid ureteroscopy (URS) and elective URS in ureteral calculi with renal colic that do not respond to analgesics.
We retrospectively analyzed the data of 690 patients with obstructive ureteral stones who underwent URS with stone retrieval. 247 patients who underwent early URS within the first 12 h were classified as group I and 443 patients who underwent elective URS as group II. Both groups were compared in terms of age, sex, creatinine, eGFR, stone size, laterality, location and number of stones, type of lithotriptor, presence of hydronephrosis and success and complication rates.
The mean age of the patients was 50.4 (18–89 years) (p > 0.05). There was no statistically significant difference between the groups in terms of age, eGFR, side, presence of hydronephrosis, fever, mucosal damage, stone migration, perforated ureter, ureteral avulsion, ureteral stent insertion at the end of the surgery and sepsis (p > 0.05). Both groups had male dominance (p > 0.05). Creatinine was significantly lower in Group I (p < 0.05). The mean stone size was also significantly lower in Group I (p < 0.05). Middle and proximal ureteral calculi were more common in Group II (p < 0.05). Multiple stones were higher in Group II (p < 0.05). The dominant type of lithotriptor used was pneumatic in Group I and laser in Group II (p < 0.05). Stone-free rates (SFRs) were higher in Group I (98% vs 90% in the first month) (p < 0.05). Postoperative hematuria and infection were more common in Group II (p < 0.05).
In selected cases, early ureteroscopy is an effective and safe method for distal ureteral calculi smaller than 10 mm that are painful and resistant to analgesic treatment.
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Shokeir AA (2001) Renal colic: pathophysiology, diagnosis and treatment. Eur Urol 39(3):241–249. https://doi.org/10.1159/000052446
Picozzi SC, Ricci C, Gaeta M, Casellato S, Stubinski R, Bozzini G, Pace G, Macchi A, Carmignani L (2012) Urgent ureteroscopy as first-line treatment for ureteral stones: a meta-analysis of 681 patients. Urol Res 40(5):581–586. https://doi.org/10.1007/s00240-012-0469-z
Shokeir AA (2002) Renal colic: new concepts related to pathophysiology, diagnosis and treatment. Curr Opin Urol 12(4):263–269
Ludwig WW, Matlaga BR (2018) Urinary stone disease: diagnosis, medical therapy, and surgical management. Med Clin North Am 102(2):265–277. https://doi.org/10.1016/j.mcna.2017.10.004
Preminger GM, Tiselius HG, Assimos DG, Alken P, Buck AC, Gallucci M, Knoll T, Lingeman JE, Nakada SY, Pearle MS, Sarica K, Türk C, Wolf JS Jr (2007) 2007 Guideline for the management of ureteral calculi. Eur Urol 52(6):1610–1631
Engeler DS, Schmid S, Schmid HP (2008) The ideal analgesic treatment for acute renal colic—theory and practice. Scand J Urol Nephrol 42(2):137–142. https://doi.org/10.1080/00365590701673716
Brown J (2006) Diagnostic and treatment patterns for renal colic in US emergency departments. Int Urol Nephrol 38(1):87–92. https://doi.org/10.1007/s11255-005-3622-6
Lammers RL, Roth BA, Utecht T (1995) Comparison of ambulance dispatch protocols for nontraumatic abdominal pain. Ann Emerg Med 26(5):579–589
Thakore S, McGugan EA, Morrison W (2002) Emergency ambulance dispatch: is there a case for triage? J R Soc Med 95(3):126–129. https://doi.org/10.1258/jrsm.95.3.126
Hollingsworth JM, Norton EC, Kaufman SR, Smith RM, Wolf JS Jr, Hollenbeck BK (2013) Medical expulsive therapy versus early endoscopic stone removal for acute renal colic: an instrumental variable analysis. J Urol 190(3):882–887. https://doi.org/10.1016/j.juro.2013.03.040
Osorio L, Lima E, Autorino R, Marcelo F (2008) Emergency management of ureteral stones: recent advances. Indian J Urol. 24(4):461–466. https://doi.org/10.4103/0970-1591.44248
Al-Ghazo MA, Ghalayini IF, Al-Azab RS, Bani Hani O, Bani-Hani I, Abuharfil M, Haddad Y (2011) Emergency ureteroscopic lithotripsy in acute renal colic caused by ureteral calculi: a retrospective study. Urol Res 39(6):497–501. https://doi.org/10.1007/s00240-011-0381-y
Sarica K, Tanriverdi O, Aydin M, Koyuncu H, Miroglu C (2011) Emergency ureteroscopic removal of ureteral calculi after first colic attack: is there any advantage? Urology 78(3):516–520. https://doi.org/10.1016/j.urology.2011.01.070
Dauw CA, Kaufman SR, Hollenbeck BK, Roberts WW, Faerber GJ, Wolf JS Jr, Hollingsworth JM (2014) Expulsive therapy versus early endoscopic stone removal in patients with acute renal colic: a comparison of indirect costs. J Urol 191(3):673–677. https://doi.org/10.1016/j.juro.2013.09.028
Tokas T, Habicher M, Junker D, Herrmann T, Jessen JP, Knoll T, Nagele U (2017) Uncovering the real outcomes of active renal stone treatment by utilizing non-contrast computer tomography: a systematic review of the current literature. World J Urol 35(6):897–905. https://doi.org/10.1007/s00345-016-1943-y
Gokce MI, Ozden E, Suer E, Gulpinar B, Gulpınar O, Tangal S (2015) Comparison of imaging modalities for detection of residual fragments and prediction of stone related events following percutaneous nephrolitotomy. Int Braz J Urol. 41(1):86–90. https://doi.org/10.1590/s1677-5538
Osorio L, Lima E, Soares J, Autorino R, Versos R, Lhamas A, Marcelo F (2007) Emergency ureteroscopic management of ureteral stones: why not? Urology 69(1):27–33. https://doi.org/10.1016/j.urology.2006.08.1116
Öğreden E, Oğuz U, Demirelli E, Benli E, Sancak EB, Gülpinar MT, Akbaş A, Reşorlu B, Ayyildiz A, Yalçin O (2016) Categorization of ureteroscopy complications and investigation of associated factors by using the modified Clavien classification system. Turk J Med Sci. 46(3):686–694. https://doi.org/10.3906/sag-1503-9
Youn JH, Kim SS, Yu JH, Sung LH, Noh CH, Chung JY (2012) Efficacy and safety of emergency ureteroscopic management of ureteral calculi. Korean J Urol. 53(9):632–635. https://doi.org/10.4111/kju.2012.53.9.632
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Ogreden, E., Demirelli, E., Aksu, M. et al. Early ureteroscopic lithotripsy in acute renal colic caused by ureteral calculi. Int Urol Nephrol 52, 15–19 (2020). https://doi.org/10.1007/s11255-019-02298-9
- Ureteral calculi
- Ureteral colic
- Early ureteroscopy
- Elective ureteroscopy