Flexible ureterscopy for the treatment of residual stones after percutaneous nephrolithotomy

Abstract

Objective To evaluate the clinical value of flexible ureterscopy for the treatment of residual stones after percutaneous nephrolithotomy (PCNL). Methods A total of 52 cases who underwent PCNL with resident stones in our hospital from December 2014 to October 2016 were included in our study. They were treated subsequently using the technique of flexible ureterscopy (retrograde intrarenal surgery, RIRS, or anterograde flexible ureterscopy, AFU, through the percutaneous access tracts). The clinic data were recorded, including the operating time, the postoperative stay, the fever and urosepsis rates, the transfusion rate, second RIRS procedure rate, the clearance rate. Results Forty-seven cases (90.4%) were treated by RIRS, with 100% successive placement of the shelf. Five cases (9.6%) were treated by AFU through the percutaneous tracts, while 2 cases failed and were successively underwent RIRS subsequently. The average time of flexible ureterscopy was 20~90 min, average (42±17) min. Among those who underwent RIRS, 5 cases (10.2%) received two RIRS procedures, while 44 cases (89.8%) received only one RIRS procedures. There were still residual stones in 4 cases after the treatment. For the complication, only two cases had the fever after the flexible ureterscopy. None of the patient who had the renal drainage and fever. No transfusion case. The post operation stays were (1.3±0.3) d. After 1~6 months of the follow up, 28 cases (84.8%) had the clearance rate. Conclusions It is safe and effective to treat the residual stones after PCNL by flexible ureterscopy. Key words: Kidney Calculi; Nephrostomy, Percutaneous; Ureteroscopes