nach oben

World Journal of Urology

Erschienen in:

20.09.2023 | Topic Paper

Flexible ureteroscopy for lower pole calculus: is it still a challenge?

verfasst von: Anil Shrestha, Baikuntha Adhikari, Frederic Panthier, Saroj Baidya, Vineet Gauhar, Olivier Traxer

Erschienen in: World Journal of Urology | Ausgabe 11/2023

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Flexible ureteroscopy (fURS) is steadily gaining popularity in the management of renal calculi, including those located in the lower pole (LP). Due to difficulty in accessing to the LP of kidney in minority of cases with fURS and reports of lower stone-free rate (SFR), it is still considered as a challenge in selected cases. The purpose of the review was to analyze the various aspects of fURS for LP stones.

Methods

An extensive review of the recent literature was done including different factors such as anatomy, preoperative stenting, stone size, flexible scopes, types of lasers, laser fibers, suction, relocation, stone-free rates, and complications.

Results

The significance of various lower pole anatomical measurements remain a subject of debate and requires standardization. Recent improvements in fURS such as single-use digital scopes with better vision and flexibility, high power laser, thulium fiber laser, smaller laser fiber, and accessories have significantly contributed to make flexible ureteroscopy more effective and safer in the management of LP stone. The utilization of thulium fiber lasers in conjunction with various suction devices is being recognized and can significantly improve SFR.

Conclusions

With the significant advancement of various aspects of fURS, this treatment modality has shown remarkable efficacy and gaining widespread acceptance in management of LP kidney stones. These developments have made the fURS of LP stones less challenging.

McClinton S, Starr K, Thomas R, MacLennan G, Lam T, Hernandez R et al (2020) The clinical and cost effectiveness of surgical interventions for stones in the lower pole of the kidney: the percutaneous nephrolithotomy, flexible ureterorenoscopy and extracorporeal shockwave lithotripsy for lower pole kidney stones randomised controlled trial (PUrE RCT) protocol. Trials 21(1):479. https://doi.org/10.1186/s13063-020-04326-xCrossRefPubMedPubMedCentral

Geraghty RM, Jones P, Somani BK (2017) Worldwide trends of urinary stone disease treatment over the last two decades: a systematic review. J Endourol 31(6):547–556. https://doi.org/10.1089/end.2016.0895CrossRefPubMed

Dresner SL, Iremashvili V, Best SL, Hedican SP, Nakada SY (2020) Influence of lower pole infundibulopelvic angle on success of retrograde flexible ureteroscopy and laser lithotripsy for the treatment of renal stones. J Endourol 34(6):655–660. https://doi.org/10.1089/end.2019.0720CrossRefPubMed

Yuri P, Hariwibowo R, Soeroharjo I, Danarto R, Hendri AZ, Brodjonegoro SR et al (2018) Meta-analysis of optimal management of lower pole stone of 10–20 mm: flexible ureteroscopy (FURS) versus extracorporeal shock wave lithotripsy (ESWL) versus percutaneus nephrolithotomy (PCNL). Acta Med Indones 50(1):18–25PubMed

Zeng G, Traxer O, Zhong W, Osther P, Pearle MS, Preminger GM et al (2023) International Alliance of Urolithiasis guideline on retrograde intrarenal surgery. BJU Int 131(2):153–164. https://doi.org/10.1111/bju.15836CrossRefPubMed

Assimos D, Krambeck A, Miller NL, Monga M, Murad MH, Nelson CP et al (2016) Surgical management of stones: American Urological Association/Endourological Society Guideline. PART I J Urol 196(4):1153–1160. https://doi.org/10.1016/j.juro.2016.05.090CrossRefPubMed

Skolarikos A, Jung H, Neisius A, Petrik A, Somani B, Thomas T, et al (2023) EAU guidelines on urolithiasis. https://uroweb.org/guidelines/urolithiasis/chapter/guidelines. Accessed 20 Feb 2023

Karim SS, Hanna L, Geraghty R, Somani BK (2020) Role of pelvicalyceal anatomy in the outcomes of retrograde intrarenal surgery (RIRS) for lower pole stones: outcomes with a systematic review of literature. Urolithiasis 48(3):263–270. https://doi.org/10.1007/s00240-019-01150-0CrossRefPubMed

Inoue T, Hamamoto S, Okada S, Imai S, Yamamichi F, Fujita M et al (2023) Pelvicalyceal anatomy on the accessibility of reusable flexible ureteroscopy to lower pole calyx during retrograde intrarenal surgery. Int J Urol 30(2):220–225. https://doi.org/10.1111/iju.15091CrossRefPubMed

10.

Tastemur S, Senel S, Kizilkan Y, Ozden C (2022) Evaluation of the anatomical factors affecting the success of retrograde intrarenal surgery for isolated lower pole kidney stones. Urolithiasis 50(1):65–70. https://doi.org/10.1007/s00240-021-01279-xCrossRefPubMed

11.

Kilicarslan H, Kaynak Y, Kordan Y, Kaygisiz O, Coskun B, Gunseren KO et al (2015) Unfavorable anatomical factors influencing the success of retrograde intrarenal surgery for lower pole renal calculi. Urol J 12(2):2065–2068PubMed

12.

Golomb D, Goldberg H, Tapiero S, Stabholz Y, Lotan P, Darawsha AE et al (2023) Retrograde intrarenal surgery for lower pole stones utilizing stone displacement technique yields excellent results. Asian J Urol 10(1):58–63. https://doi.org/10.1016/j.ajur.2021.09.001CrossRefPubMed

13.

Giulioni C, Castellani D, Somani BK, Chew BH, Tailly T, Keat WOL et al (2023) The efficacy of retrograde intra-renal surgery (RIRS) for lower pole stones: results from 2946 patients. World J Urol. https://doi.org/10.1007/s00345-023-04363-6CrossRefPubMedPubMedCentral

14.

Assimos D, Crisci A, Culkin D, Xue W, Roelofs A, Duvdevani M et al (2016) Preoperative JJ stent placement in ureteric and renal stone treatment: results from the Clinical Research Office of Endourological Society (CROES) ureteroscopy (URS) Global Study. BJU Int 117(4):648–654. https://doi.org/10.1111/bju.13250CrossRefPubMed

15.

Chen H, Pan Y, Xiao M, Yang J, Wei Y (2022) The outcomes of pre-stenting on renal and ureteral stones: a meta-analysis. Urol Int 106(5):495–503. https://doi.org/10.1159/000519473CrossRefPubMed

16.

Mahajan PM, Padhye AS, Bhave AA, Sovani YB, Kshirsagar YB, Bapat SS (2009) Is stenting required before retrograde intrarenal surgery with access sheath. Indian J Urol 25(3):326–328. https://doi.org/10.4103/0970-1591.56185CrossRefPubMedPubMedCentral

17.

Yuk HD, Park J, Cho SY, Sung LH, Jeong CW (2020) The effect of preoperative ureteral stenting in retrograde intrarenal surgery: a multicenter, propensity score-matched study. BMC Urol 20(1):147. https://doi.org/10.1186/s12894-020-00715-1CrossRefPubMedPubMedCentral

18.

Assantachai K, Srinualnad S, Leewansangtong S, Taweemonkongsap T, Liangkobkit K, Chotikawanich E (2023) Surgical outcomes of patients who underwent retrograde intrarenal surgery using a ureteral access sheath to manage kidney stones sized 1–2 cm compared between patients who did and did not undergo preoperative ureteral stenting. Heliyon. 9(5):e15801. https://doi.org/10.1016/j.heliyon.2023.e15801CrossRefPubMedPubMedCentral

19.

Lee MH, Lee IJ, Kim TJ, Lee SC, Jeong CW, Hong SK et al (2019) The effect of short-term preoperative ureteral stenting on the outcomes of retrograde intrarenal surgery for renal stones. World J Urol 37(7):1435–1440. https://doi.org/10.1007/s00345-018-2519-9CrossRefPubMed

20.

Chang X, Wang Y, Li J, Han Z (2021) Prestenting versus nonprestenting on the outcomes of flexible ureteroscopy for large upper urinary stones: a systematic review and meta-analysis. Urol Int 105(7–8):560–567. https://doi.org/10.1159/000506652CrossRefPubMed

21.

Law YXT, Teoh JYC, Castellani D, Lim EJ, Chan EOT, Wroclawski M et al (2022) Role of pre-operative ureteral stent on outcomes of retrograde intra-renal surgery (RIRS): systematic review and meta-analysis of 3831 patients and comparison of Asian and non-Asian cohorts. World J Urol 40(6):1377–1389. https://doi.org/10.1007/s00345-022-03935-2CrossRefPubMed

22.

Dragos LB, Somani BK, Sener ET, Buttice S, Proietti S, Ploumidis A, et al. (2017) Which flexible ureteroscopes (Digital vs. Fiber-Optic) Can easily reach the difficult lower pole calices and have better end-tip deflection: in vitro study On K-box. A PETRA evaluation. J Endourol 31(7):630–7. https://doi.org/10.1089/end.2017.0109.

23.

Somani BK, Al-Qahtani SM, de Medina SD, Traxer O (2013) Outcomes of flexible ureterorenoscopy and laser fragmentation for renal stones: comparison between digital and conventional ureteroscope. Urology 82(5):1017–1019. https://doi.org/10.1016/j.urology.2013.07.017CrossRefPubMed

24.

Kam J, Yuminaga Y, Beattie K, Ling KY, Arianayagam M, Canagasingham B et al (2019) Single use versus reusable digital flexible ureteroscopes: A prospective comparative study. Int J Urol 26(10):999–1005. https://doi.org/10.1111/iju.14091CrossRefPubMed

25.

Scotland KB, Chan JYH, Chew BH (2019) Single-use flexible ureteroscopes: how do they compare with reusable ureteroscopes? J Endourol 33(2):71–78. https://doi.org/10.1089/end.2018.0785CrossRefPubMed

26.

Bragaru M, Multescu R, Geavlete P, Popescu R, Geavlete B (2023) Comparison of flexible ureteroscope performance between reusable and single-use models. J Clin Med. 12(3):1093. https://doi.org/10.3390/jcm12031093CrossRefPubMedPubMedCentral

27.

Ventimiglia E, Somani BK, Traxer O (2020) Flexible ureteroscopy: reuse? Or is single use the new direction? Curr Opin Urol 30(2):113–119. https://doi.org/10.1097/mou.0000000000000700CrossRefPubMed

28.

Göger YE, Özkent MS, Kılınç MT, Taşkapu HH, Göger E, Aydın A et al (2021) Efficiency of retrograde intrarenal surgery in lower pole stones: disposable flexible ureterorenoscope or reusable flexible ureterorenoscope? World J Urol 39(9):3643–3650. https://doi.org/10.1007/s00345-021-03656-yCrossRefPubMed

29.

Salvadó JA, Cabello JM, Moreno S, Cabello R, Olivares R, Velasco A (2019) Endoscopic treatment of lower pole stones: is a disposable ureteroscope preferable? Results of a prospective case-control study. Cent Eur J Urol 72(3):280–284. https://doi.org/10.5173/ceju.2019.1962CrossRef

30.

Usawachintachit M, Isaacson DS, Taguchi K, Tzou DT, Hsi RS, Sherer BA et al (2017) A prospective case-control study comparing lithovue, a single-use, flexible disposable ureteroscope, with flexible, reusable fiber-optic ureteroscopes. J Endourol 31(5):468–475. https://doi.org/10.1089/end.2017.0027CrossRefPubMedPubMedCentral

31.

Mager R, Kurosch M, Höfner T, Frees S, Haferkamp A, Neisius A (2018) Clinical outcomes and costs of reusable and single-use flexible ureterorenoscopes: a prospective cohort study. Urolithiasis 46(6):587–593. https://doi.org/10.1007/s00240-018-1042-1CrossRefPubMed

32.

Yang E, Jing S, Niu Y, Qi S, Yadav PK, Yang L et al (2021) Single-use digital flexible ureteroscopes as a safe and effective choice for the treatment of lower pole renal stones: secondary analysis of a randomized-controlled trial. J Endourol 35(12):1773–1778. https://doi.org/10.1089/end.2021.0170CrossRefPubMed

33.

Gauhar V, Chai CA, Chew BH, Singh A, Castellani D, Tailly T et al (2023) RIRS with disposable or reusable scopes: does it make a difference? Results from the multicenter FLEXOR study. Ther Adv Urol 15:17562872231158072. https://doi.org/10.1177/17562872231158072CrossRefPubMedPubMedCentral

34.

Legemate JD, Kamphuis GM, Freund JE, Baard J, Zanetti SP, Catellani M et al (2019) Durability of flexible ureteroscopes: a prospective evaluation of longevity, the factors that affect it, and damage mechanisms. Eur Urol Focus 5(6):1105–1111. https://doi.org/10.1016/j.euf.2018.03.001CrossRefPubMed

35.

Martin CJ, McAdams SB, Abdul-Muhsin H, Lim VM, Nunez-Nateras R, Tyson MD et al (2017) The economic implications of a reusable flexible digital ureteroscope: a cost-benefit analysis. J Urol 197(3 Pt 1):730–735. https://doi.org/10.1016/j.juro.2016.09.085CrossRefPubMed

36.

Lildal SK, Andreassen KH, Baard J, Brehmer M, Bultitude M, Eriksson Y et al (2021) Consultation on kidney stones, Copenhagen 2019: aspects of intracorporeal lithotripsy in flexible ureterorenoscopy. World J Urol 39(6):1673–1682. https://doi.org/10.1007/s00345-020-03481-9CrossRefPubMed

37.

Inoue T, Yamamichi F, Okada S, Hamamoto S, Fujisawa M (2020) Change in irrigation flow through a flexible ureteroscope with various devices in the working channel: comparison between an automatic irrigation pump and gravity-based irrigation. Int J Urol 27(4):333–338. https://doi.org/10.1111/iju.14197CrossRefPubMed

38.

Villa L, Ventimiglia E, Proietti S, Giusti G, Briganti A, Salonia A et al (2020) Does working channel position influence the effectiveness of flexible ureteroscopy? Results from an in vitro study. BJU Int 125(3):449–456. https://doi.org/10.1111/bju.14923CrossRefPubMed

39.

Doizi S, Traxer O (2018) Flexible ureteroscopy: technique, tips and tricks. Urolithiasis 46(1):47–58. https://doi.org/10.1007/s00240-017-1030-xCrossRefPubMed

40.

Fried NM, Irby PB (2018) Advances in laser technology and fibre-optic delivery systems in lithotripsy. Nat Rev Urol 15(9):563–573. https://doi.org/10.1038/s41585-018-0035-8CrossRefPubMed

41.

Terry RS, Whelan PS, Lipkin ME (2020) New devices for kidney stone management. Curr Opin Urol 30(2):144–148. https://doi.org/10.1097/mou.0000000000000710CrossRefPubMed

42.

Traxer O, Keller EX (2020) Thulium fiber laser: the new player for kidney stone treatment? A comparison with Holmium: YAG laser. World J Urol 38(8):1883–1894. https://doi.org/10.1007/s00345-019-02654-5CrossRefPubMed

43.

Petzold R, Miernik A, Suarez-Ibarrola R (2021) In vitro dusting performance of a new solid state thulium laser compared to holmium laser lithotripsy. J Endourol 35(2):221–225. https://doi.org/10.1089/end.2020.0525CrossRefPubMed

44.

Panthier F, Pauchard F, Traxer O (2023) Retrograde intra renal surgery and safety: pressure and temperature. A systematic review. Curr Opin Urol 33(4):308–317. https://doi.org/10.1097/mou.0000000000001102CrossRefPubMed

45.

Ulvik Ø, Æsøy MS, Juliebø-Jones P, Gjengstø P, Beisland C (2022) Thulium fibre laser versus holmium: YAG for ureteroscopic lithotripsy: outcomes from a prospective randomised clinical trial. Eur Urol 82(1):73–79. https://doi.org/10.1016/j.eururo.2022.02.027CrossRefPubMed

46.

Kraft L, Yilmaz M, Petzold R, Gratzke C, Suarez-Ibarrola R, Miernik A (2022) Dusting efficiency of a novel pulsed thulium: yttrium aluminum garnet laser vs a thulium fiber laser. J Endourol 36(2):259–265. https://doi.org/10.1089/end.2021.0441CrossRefPubMed

47.

Epidemiologie Des Urgences Urologiques En C.H.U.: Accessed

48.

Panthier F, Doizi S, Lapouge P, Chaussain C, Kogane N, Berthe L et al (2021) Comparison of the ablation rates, fissures and fragments produced with 150 µm and 272 µm laser fibers with superpulsed thulium fiber laser: an in vitro study. World J Urol 39(6):1683–1691. https://doi.org/10.1007/s00345-020-03186-zCrossRefPubMed

49.

Sierra A, Corrales M, Piñero A, Kolvatzis M, Somani B, Traxer O (2022) Glossary of pre-settings given by laser companies: no consensus! World J Urol 40(9):2313–2321. https://doi.org/10.1007/s00345-022-04090-4CrossRefPubMed

50.

Sierra A, Corrales M, Piñero A, Traxer O (2022) Thulium fiber laser pre-settings during ureterorenoscopy: Twitter’s experts’ recommendations. World J Urol 40(6):1529–1535. https://doi.org/10.1007/s00345-022-03966-9CrossRefPubMed

51.

Aldoukhi AH, Roberts WW, Hall TL, Teichman JMH, Ghani KR (2018) Understanding the popcorn effect during holmium laser lithotripsy for dusting. Urology 122:52–57. https://doi.org/10.1016/j.urology.2018.08.031CrossRefPubMed

52.

Louters MM, Dau JJ, Hall TL, Ghani KR, Roberts WW (2022) Laser operator duty cycle effect on temperature and thermal dose: in-vitro study. World J Urol 40(6):1575–1580. https://doi.org/10.1007/s00345-022-03967-8CrossRefPubMed

53.

Haddad M, Emiliani E, Rouchausse Y, Coste F, Doizi S, Berthe L et al (2017) Impact of the curve diameter and laser settings on laser fiber fracture. J Endourol 31(9):918–921. https://doi.org/10.1089/end.2017.0006CrossRefPubMed

54.

Uzan A, Chiron P, Panthier F, Haddad M, Berthe L, Traxer O et al (2021) Comparison of holmium: YAG and thulium fiber lasers on the risk of laser fiber fracture. J Clin Med. 10(13):2960. https://doi.org/10.3390/jcm10132960CrossRefPubMedPubMedCentral

55.

Bourdoumis A, Christopoulos P, Raj N, Fedder A, Buchholz N (2016) A comparative in vitro study of power output deterioration over time between Ho: YAG laser fibers from different manufacturers as a function of deflection and power input. Curr Urol 9(1):12–18. https://doi.org/10.1159/000442844CrossRefPubMedPubMedCentral

56.

Keller EX, De Coninck V, Doizi S, Daudon M, Traxer O (2021) What is the exact definition of stone dust? An in vitro evaluation. World J Urol 39(1):187–194. https://doi.org/10.1007/s00345-020-03178-zCrossRefPubMed

57.

Buell MI, Amasyali AS, Chen N, Belle JD, Keheila M, Baldwin EA et al (2022) Thulium versus holmium for in situ lower pole laser lithotripsy. Can J Urol 29(6):11371–11377PubMed

58.

Kallidonis P, Ntasiotis P, Somani B, Adamou C, Emiliani E, Knoll T et al (2020) Systematic review and meta-analysis comparing percutaneous nephrolithotomy, retrograde intrarenal surgery and shock wave lithotripsy for lower pole renal stones less than 2 cm in maximum diameter. J Urol 204(3):427–433. https://doi.org/10.1097/ju.0000000000001013CrossRefPubMed

59.

Bozzini G, Verze P, Arcaniolo D, Dal Piaz O, Buffi NM, Guazzoni G et al (2017) A prospective randomized comparison among SWL, PCNL and RIRS for lower calyceal stones less than 2 cm: a multicenter experience : A better understanding on the treatment options for lower pole stones. World J Urol 35(12):1967–1975. https://doi.org/10.1007/s00345-017-2084-7CrossRefPubMed

60.

Kandemir A, Guven S, Balasar M, Sonmez MG, Taskapu H, Gurbuz R (2017) A prospective randomized comparison of micropercutaneous nephrolithotomy (Microperc) and retrograde intrarenal surgery (RIRS) for the management of lower pole kidney stones. World J Urol 35(11):1771–1776. https://doi.org/10.1007/s00345-017-2058-9CrossRefPubMed

61.

Ur Rehman O, Imran M, Rafaqat M, Haider FUR, Rehman A, Farooq U et al (2023) Outcomes in lower pole kidney stone management using mini-percutaneous nephrolithotomy compared with retrograde intra renal surgery: a randomized controlled trial. Cureus. 15(2):e35343. https://doi.org/10.7759/cureus.35343CrossRefPubMedPubMedCentral

62.

Liu X, Xia D, Peng E, Tong Y, Liu H, Wang X et al (2022) Comparison of two techniques for the management of 2–3 cm lower pole renal calculi in obese patients. World J Urol 40(2):513–518. https://doi.org/10.1007/s00345-021-03872-6CrossRefPubMed

63.

Pillai SB, Chawla A, de la Rosette J, Laguna P, Guddeti R, Reddy SJ et al (2022) Super-mini percutaneous nephrolithotomy (SMP) vs retrograde intrarenal surgery (RIRS) in the management of renal calculi ≤ 2 cm: a propensity matched study. World J Urol 40(2):553–562. https://doi.org/10.1007/s00345-021-03860-wCrossRefPubMed

64.

Awedew AF, Seman YS, Yalew DZ, Wondmeneh YC, Yigzaw WA (2023) Efficacy and safety of surgical treatment for 1–2 cm sized lower pole of renal stone: network meta-analysis of randomized control trials. Urolithiasis 51(1):82. https://doi.org/10.1007/s00240-023-01454-2CrossRefPubMed

65.

Panthier F, Doizi S, Illoul L, Berthe L, Traxer O (2021) Developing free three-dimensional software for surgical planning for kidney stones: volume is better than diameter. Eur Urol Focus 7(3):589–590. https://doi.org/10.1016/j.euf.2020.06.003CrossRefPubMed

66.

Sari S, Ozok HU, Topaloglu H, Cakici MC, Ozdemir H, Karakoyunlu AN et al (2017) The association of a number of anatomical factors with the success of retrograde intrarenal surgery in lower calyceal stones. Urol J 14(4):4008–4014PubMed

67.

Sebaey A, Taleb AA, Elbashir S, Gomaa R, Elshazli A, Saber W (2022) Flexible ureterorenoscopy (RIRS) vs. Mini- percutaneous nephrolithotomy (MINI-PCNL) for renal stones 20–30 mm a prospective randomized study. African J Urol 28(1):13. https://doi.org/10.1186/s12301-022-00278-7CrossRef

68.

Li Z, Lai C, Shah AK, Xie W, Liu C, Huang L et al (2020) Comparative analysis of retrograde intrarenal surgery and modified ultra-mini percutaneous nephrolithotomy in management of lower pole renal stones (1.5–3.5 cm). BMC Urology. 20(1):27. https://doi.org/10.1186/s12894-020-00586-6CrossRefPubMedPubMedCentral

69.

Jessen JP, Honeck P, Knoll T, Wendt-Nordahl G (2014) Flexible ureterorenoscopy for lower pole stones: influence of the collecting system’s anatomy. J Endourol 28(2):146–151. https://doi.org/10.1089/end.2013.0401CrossRefPubMed

70.

Shrestha A, Adhikari B, Shah AK (2023) Does relocation of lower pole stone during retrograde intrarenal surgery improve stone-free rate? A prospective randomized study. J Endourol 37(1):21–7. https://doi.org/10.1089/end.2022.0050CrossRefPubMed

71.

Yaghoubian AJ, Anastos H, Khusid JA, Shimonov R, Lundon DJ, Khargi R et al (2023) Displacement of lower pole stones during retrograde intrarenal surgery improves stone-free status: a prospective randomized controlled trial. J Urol 209(5):963–970. https://doi.org/10.1097/ju.0000000000003199CrossRefPubMed

72.

Baghdadi M, Emiliani E, Talso M, Servián P, Barreiro A, Orosa A et al (2017) Comparison of laser fiber passage in ureteroscopic maximum deflection and their influence on deflection and irrigation: Do we really need the ball tip concept? World J Urol 35(2):313–318. https://doi.org/10.1007/s00345-016-1873-8CrossRefPubMed

73.

Donaldson JF, Lardas M, Scrimgeour D, Stewart F, MacLennan S, Lam TB et al (2015) Systematic review and meta-analysis of the clinical effectiveness of shock wave lithotripsy, retrograde intrarenal surgery, and percutaneous nephrolithotomy for lower-pole renal stones. Eur Urol 67(4):612–616. https://doi.org/10.1016/j.eururo.2014.09.054CrossRefPubMed

74.

Danilovic A, Cavalanti A, Rocha BA, Traxer O, Torricelli FCM, Marchini GS et al (2018) Assessment of residual stone fragments after retrograde intrarenal surgery. J Endourol 32(12):1108–1113. https://doi.org/10.1089/end.2018.0529CrossRefPubMed

75.

Gauhar V, Teoh JY, Mulawkar PM, Tak GR, Wroclawski ML, Robles-Torres JI et al (2022) Comparison and outcomes of dusting versus stone fragmentation and extraction in retrograde intrarenal surgery: results of a systematic review and meta-analysis. Cent Eur J Urol 75(3):317–327. https://doi.org/10.5173/ceju.2022.0148CrossRef

76.

Inoue T, Okada S, Hamamoto S, Fujisawa M (2021) Retrograde intrarenal surgery: past, present, and future. Investig Clin Urol 62(2):121–135. https://doi.org/10.4111/icu.20200526CrossRefPubMedPubMedCentral

77.

Gauhar V, Somani BK, Heng CT, Gauhar V, Chew BH, Sarica K et al (2022) Technique, feasibility, utility, limitations, and future perspectives of a new technique of applying direct in-scope suction to improve outcomes of retrograde intrarenal surgery for stones. J Clin Med. 11(19):5710. https://doi.org/10.3390/jcm11195710CrossRefPubMedPubMedCentral

78.

Gauhar V, Traxer O, Mohammed S, Hamri SB, Lim EJ, Khi Yung F et al (2022) Three different techniques to show utility and outcomes of suction in retrograde intrarenal surgery. Eur Urol Open Sci 39:S131–S132. https://doi.org/10.1016/S2666-1683(22)00191-4CrossRef

79.

Gauhar V, Traxer O, Castellani D, Ragoori D, Heng CT, Chew BH et al (2023) A feasibility study on clinical utility, efficacy and limitations of two types of flexible and navigable suction ureteral access sheaths in retrograde intrarenal surgery for renal stones. Urology. https://doi.org/10.1016/j.urology.2023.05.032CrossRefPubMedPubMedCentral

80.

Sur RL, Agrawal S, Eisner BH, Haleblian GE, Ganpule AP, Sabnis RB et al (2022) Initial safety and feasibility of steerable ureteroscopic renal evacuation: a novel approach for the treatment of urolithiasis. J Endourol 36(9):1161–1167. https://doi.org/10.1089/end.2021.0759CrossRefPubMedPubMedCentral

81.

Giulioni C, Castellani D, Traxer O, Gadzhiev N, Pirola GM, Tanidir Y et al (2023) Experimental and clinical applications and outcomes of using different forms of suction in retrograde intrarenal surgery. Results from a systematic review. Actas Urol Esp (Engl Ed). https://doi.org/10.1016/j.acuroe.2023.06.001CrossRefPubMed

82.

Forbes CM, Rebullar KA, Teichman JMH (2018) Comparison of flexible ureteroscopy damage rates for lower pole renal stones by laser fiber type. Lasers Surg Med 50(8):798–801. https://doi.org/10.1002/lsm.22822CrossRefPubMed

Titel: Flexible ureteroscopy for lower pole calculus: is it still a challenge?
verfasst von: Anil Shrestha
Baikuntha Adhikari
Frederic Panthier
Saroj Baidya
Vineet Gauhar
Olivier Traxer
Publikationsdatum: 20.09.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 11/2023
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-023-04606-6

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Flexible ureteroscopy for lower pole calculus: is it still a challenge?

Abstract

Purpose

Methods

Results

Conclusions

Neu im Fachgebiet Urologie

Mit dem Seitenschneider gegen das Reißverschluss-Malheur

Patrone im Penis bringt Urologen in Gefahr

15% bedauern gewählte Blasenkrebs-Therapie

Costims – das nächste heiße Ding in der Krebstherapie?

Update Urologie

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 11/2023

Effect of Ho:YAG laser on kidney tissue with Virtual Basket™ and Bubble Blast™ pulse modulation: an experimental ex vivo study

Generative AI: in rescue of healthcare reformation

ChatGPT and most frequent urological diseases: comment

Risk factors, treatment modalities, and clinical outcomes of penile calciphylaxis: systematic review

Single-use digital flexible cystoscope for double J removal versus reusable instruments: a prospective, comparative study of functionality, risk of infection, and costs

Is day-case surgery feasible for laser endoscopic enucleation of the prostate? A systematic review

Neu im Fachgebiet Urologie

Mit dem Seitenschneider gegen das Reißverschluss-Malheur

Patrone im Penis bringt Urologen in Gefahr

15% bedauern gewählte Blasenkrebs-Therapie

Costims – das nächste heiße Ding in der Krebstherapie?

Update Urologie