Abstract
BackgroundThe current study aimed to assess a novel ureteroscopic technique developed for treating upper urinary calculi based on a specially designed lateral decubitus body position that could avoid stone loss by adjusting to the effects of gravity.MethodsThis retrospective study examined patients with upper urinary calculi who were surgically treated from November 2008 to January 2020, using a new body position and a rigid ureteroscope. Clinical outcomes, stone-free rates, operative times and complications were evaluated, and factors that could influence treatment success were determined.ResultsIn total, 1080 patients were included, and 1145 operations were performed. The maximum calculus diameters were 11.22 ± 5.01 mm. Operative times were 48.60 ± 27.44 min. A total of 1042 cases were successfully treated, with a stone-free rate of 91.00%. Multivariate analysis showed that female sex (OR = 2.135, 95% CI 1.332–3.422, P = 0.002), thin scope standby (OR = 1.643, 95% CI 1.074–2.514, P = 0.022), laser lithotripsy (OR = 5.087, 95% CI 2.400–10.785, P = 0.000) and stone size (OR = 0.946, 95% CI 0.912–0.981, P = 0.003) were independently associated with stone-free outcomes. In total, 2 ureteral perforations, 2 ureteric avulsions and 4 urosepsis cases were observed, but were all cured without sequelae.ConclusionsUreteroscopic lithotripsy in the lateral decubitus position is a safe and effective technique for treating upper urinary tract calculi, especially upper ureteral calculi.
Highlights
The current study aimed to assess a novel ureteroscopic technique developed for treating upper urinary calculi based on a specially designed lateral decubitus body position that could avoid stone loss by adjusting to the effects of gravity
The inclusion criteria were age > 16 years, ureteroscopic lithotripsy performed in the lateral decubitus body position and 1-month postoperative follow-up
Since lateral decubitus surgery has been a routine operation in our hospital for a long time, there were no comparative data on ureteroscopic lithotripsy in the lithotomy position for upper urinary stones in the same center
Summary
The current study aimed to assess a novel ureteroscopic technique developed for treating upper urinary calculi based on a specially designed lateral decubitus body position that could avoid stone loss by adjusting to the effects of gravity. The treatment of urinary tract stones has been greatly improved, and new technologies and instruments provide more choices for managing all types of calculi. The. Zhang et al BMC Urology (2022) 22:24 pelvis and calices are lower than the ureter; retrogradely migrating ureteral stones will tend to fall into the kidney along the slope of the pelvis (Fig. 1A). The stones will no longer be reachable by the instrument. Using a laser, this problem becomes slightly less prominent, but ureteral stone retropulsion still occurs [6]
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