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Sky is no limit for ureteroscopy: extending the indications and special circumstances

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Abstract

Purpose

To critically review and synthesize data of ureteroscopy (URS) in different circumstances that all urologists may encounter during everyday clinical practice, such as pregnancy, obesity, bleeding diathesis, renal stones larger than 2 cm, calyceal diverticula, and kidney malformations.

Methods

According to PRISMA guidelines, a systematic literature review was performed to identify articles published between 1990 and December 2013 that reported different indications and special circumstances for URS. Articles were separated into the following categories: pregnancy, obesity, bleeding diathesis, stones larger than 2 cm in diameter, calyceal diverticula, and kidney malformations. We used a narrative synthesis for the analyses of the studies, including a description of the characteristics and main outcomes reported in the articles.

Results

Records identified through database searching were 1396; at the end of study selection, articles included were 57. The majority of these are retrospective studies and involve small cohorts of patients. There does not exist a consensus about important parameters in ureterorenoscopy like stone size, stone free status and complication rate.

Conclusion

Ureteroscopy is effective and reliable tool capable of treating the majority of stones even in the most complicated clinical scenarios and will have more fundamental roles in endourology. The lack of definitive conclusions is due to the great heterogeneity in collecting study’s results; multicentric randomized trials that define in advance the parameters to be studied should be encouraged.

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Acknowledgments

The authors thank Boldface Editors for reviewing the linguistic style of the manuscript.

Conflict of interest

Guido Giusti is a consultant for Boston Scientific, Cook Medical, Porges, Storz; Silvia Proietti, Roberto Peschechera, Giuseppe Sortino, Gianluigi Taverna, Pierpaolo Graziotti, and Luca Cindolo have nothing to disclose.

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Authors and Affiliations

  1. Urology Department, Humanitas Clinical and Research Center, Rozzano, Italy

    Guido Giusti, Silvia Proietti, Roberto Peschechera, Gianluigi Taverna, Giuseppe Sortino & Pierpaolo Graziotti

  2. Urology Department, “S.Pio da Pietrelcina” Hospital, Vasto, Italy

    Luca Cindolo

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  1. Guido Giusti
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Giusti, G., Proietti, S., Peschechera, R. et al. Sky is no limit for ureteroscopy: extending the indications and special circumstances. World J Urol 33, 257–273 (2015). https://doi.org/10.1007/s00345-014-1345-y

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