You have accessJournal of UrologyCME1 May 2022MP14-05 URETEROSCOPY UNDER CONSCIOUS SEDATION FOR UPPER TRACT PATHOLOGY Kunal Jain, Esha Jain, Ruben Blachman-Braun, Amanda Eng, Brian Peters, and Premal Patel Kunal JainKunal Jain More articles by this author , Esha JainEsha Jain More articles by this author , Ruben Blachman-BraunRuben Blachman-Braun More articles by this author , Amanda EngAmanda Eng More articles by this author , Brian PetersBrian Peters More articles by this author , and Premal PatelPremal Patel More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002543.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureteroscopies are commonly performed under general anesthesia to maximize patient tolerability and minimize surgical complications. However, given the improvements in endoscopic technology and risks associated with general anesthesia, alternate forms of anesthesia have been postulated. We aimed to evaluate the outcomes of ureteroscopy for the entire upper urinary tract under conscious sedation. METHODS: We completed a retrospective cohort study from November 2019 to June 2020 at a tertiary-level hospital. All ureteroscopies that were performed with physician-directed, nursing-administered intravenous sedation were included. Our primary outcome was success rate. Secondary outcomes included: stone-free rate, intra-operative complication rate, hospital admission rate, and sedation requirement. Univariate- and multivariate-adjusted logistic regression analyses were employed. RESULTS: In total, 99 ureteroscopies were included: 73 (73.7%) for urolithiasis, 24 (24.2%) for urothelial carcinoma, and 2 (2.0%) for ureteric obstruction. The overall success rate was 83.8% (83/99). The stone-free rate was 80.8% (59/73). No intra-operative complications, nor hospital admissions, were reported. The mean amount of sedation required was 3 [interquartile range: 2–4] mg of midazolam and 100 [100–150] μg of fentanyl. On multivariate analysis, midazolam was significantly associated with increased success [odds ratio: 2.496, 95% confidence interval: 1.057–5.892; p=0.037]. CONCLUSIONS: For the first time in literature, we have shown that ureteroscopy under conscious sedation is safe and effective when evaluating upper tract pathology. We were limited by our small sample size, selection bias to chose healthy patients, and lack of patient tolerability data. Patient selection is paramount when identifying appropriate candidates for this approach. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e233 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kunal Jain More articles by this author Esha Jain More articles by this author Ruben Blachman-Braun More articles by this author Amanda Eng More articles by this author Brian Peters More articles by this author Premal Patel More articles by this author Expand All Advertisement PDF DownloadLoading ...