MP28-17 LUBRIGLIDE SEQUENTIAL URETERAL DILATORS®: A SAFE AND EFFECTIVE METHOD OF URETERAL DILATION TO FACILITATE PRIMARY URETEROSCOPIC INTERVENTION.

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy II1 Apr 2015MP28-17 LUBRIGLIDE SEQUENTIAL URETERAL DILATORS®: A SAFE AND EFFECTIVE METHOD OF URETERAL DILATION TO FACILITATE PRIMARY URETEROSCOPIC INTERVENTION. Christopher Mitchell, Benjamin McCormick, Tracy Marien, and Nicole Miller Christopher MitchellChristopher Mitchell More articles by this author , Benjamin McCormickBenjamin McCormick More articles by this author , Tracy MarienTracy Marien More articles by this author , and Nicole MillerNicole Miller More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1240AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In patients with nephrolithiasis undergoing primary ureteroscopy, a percentage will require a secondary procedure due to inability to successfully pass an ureteroscope to the stone. Certain interventions, such as ureteral dilation can be performed to increase the likelihood of accessing the ureter to complete the procedure. Thus, we sought to access the safety and efficacy of using Lubriglide sequential ureteral dilators® (Boston Scientific) to promote primary ureteroscopy without need for prestenting. METHODS Retrospective review was performed of a consecutive series of patients undergoing primary ureteroscopy by a single surgeon (NLM) from January 2011 to August 2013. The primary outcome of interest was to characterize the use, safety, and efficacy of sequential ureteral dilators to promote stone treatment during ureteroscopy. No funding was obtained for this study. RESULTS A total of 316 non-prestented patients underwent attempted primary ureteroscopy over the study period. Thirty patients underwent bilateral procedures. Median age was 54 years (IQR: 40-63) with 161 (50.9%) patients male and 155 (49.1%) female. Stone location was renal in 211 cases, proximal ureter in 51 cases, mid ureter in 18 cases, and distal ureter in 36 cases. Median stone size was 9 mm (IQR: 7-12). Rigid ureteroscopy only was performed in 40 (12.7%) cases, while in the remaining 276 (87.3%) flexible ureteroscopy was performed. Use of sequential ureteral dilators to promote ureteral access was performed in 109 (34.5%) cases and was successful to allow completion of the procedure in 102 (93.6%) cases. No intraoperative complications occurred while performing sequential ureteral dilation. A total of 14 patients (4.3%) required ureteral stent placement for passive ureteral dilation, with definitive stone treatment at a later date. Post-operative radiographic follow-up was available for 272 (86.1%) patients and no ureteral strictures were detected in the ureteral dilation group, while 1 patient in the non-dilation group was found to have a ureteral stricture. CONCLUSIONS Approximately 1/3 of non-prestented patients may require ureteral dilation for successful completion of primary ureteroscopy. Use of sequential ureteral dilators may significantly decrease the need for presenting and a secondary procedure to complete stone treatment. Thus we conclude that sequential ureteral dilators are a safe and effective method to perform ureteral dilation to promote ureteral access and allow for successful stone treatment in one setting © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e317 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christopher Mitchell More articles by this author Benjamin McCormick More articles by this author Tracy Marien More articles by this author Nicole Miller More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...