Is fluoroscopy-free single-use flexible ureteroscopy a feasible treatment for kidney stones with abnormal renal anatomy?

Abstract

ObjectiveTo evaluate the feasibility of fluoroscopy-free single-use flexible ureteroscopy procedure in the treatment of kidney stones with abnormal renal anatomy compared to normal renal anatomy. MethodsForty patients with abnormal and 80 patients with normal renal anatomy who had 10–20 mm renal stones were included. They were treated with LithoVue single-use fURS (Boston Scientific, Marlborough, MA, USA) after ureteric dilatation by two different size semi-rigid ureteroscopes. This technique was chosen as the aim was to exclude any ureteric pathology (e.g., stone or stricture), confirm the placement of a safe guidewire, avoid balloon dilatation of the ureter, and achieve safe insertion of 12 Fr, 35/45 cm ureteric access sheath with optical and tactile sign and without fluoroscopy image for guidance. ResultsMean age s were 43 years and 45 years in group A and group B, respectively. The mean stone burden was 14.62 (standard deviation: 5.35) mm3 and 14.79 (standard deviation: 4.58) mm3 in Group A and Group B, respectively. There is no significant difference between both groups according to mean operative time, hospital stay, or stone-free rate. stone-free rate was about 93% in both groups when the stone size was between 10 mm and 15 mm, and less than 60% when the stone size was between 15 mm and 20 mm. In the majority of cases (80% in Group A and 92.5% in Group B), we completed the procedure without fluoroscopy. The perioperative complication rates were comparable in the two groups. ConclusionFluoroscopy-free single-use flexible ureteroscopy, when performed by expert urologist, is a feasible treatment for pre-stented patients with kidney calculi of <15 mm with abnormal renal anatomy.