Staff Members - Benha University
Fluoroless-ureteroscopy for definitive management of distal ureteral calculi: randomized controlled trial
• 2018
Publication Information
Authors
Ahmed Mohey, MD, Mohamed Alhefnawy, MD, Mostafa Mahmoud, MD,
Rabea Gomaa, MD, Tarek Soliman, MD, Shabieb Ahmed, MD,
Yasser A. Noureldin, MD
Keywords
ureteroscopy, fluoroscopy, management,
ureteral calculi, outcomes
Journal
Not Available
Publisher
Not Available
Volume
Not Available
Issue
Not Available
Pages
Not Available
publication.type
International
Paper Link
Not Available
Supplementary Materials
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Abstract
MOHEY A, ALHEFNAWY M, MAHMOUD M,
GOMAA R, SOLIMAN T, AHMED S, NOURELDIN
YA. Fluoroless ureteroscopy for definitive
management of distal ureteral calculi: randomized
controlled trial. Can J Urol 2018;25(1):0000-0000.
Introduction: To assess the conversion rate during
fluoroless-ureteroscopy (URS) and evaluate the feasibility,
safety, and efficacy of fluoroless-URS as a definitive
management of distal ureteral calculi.
Material and methods: Between May 2013 and August
2015, patients with radio-opaque distal ureteral calculi
of ≤ 1 cm in size were randomized to undergo fluoroless-
URS or standard URS. Patients with previous ureteral
surgery, ureteral kinking, ureteral stricture, single kidney,
additional proximal ureteral or renal calculi, uncontrolled
coagulopathy, and/or congenital anomalies of the urinary
tract were excluded. Patients’ demographics, stone
characteristics, operative data, stone free status, and
complications were compared between both groups.
Results: Seventy-four cases in the fluoroless-URS
group were compared with 80 cases in the standard-URS
group. There was no significant difference in the baseline
characteristics between both groups in terms of the mean
patient’s age (28.8 ± 13.3 versus 29.5 ± 14.6 years;
p = 0.76), body mass index (28.2 ± 33 versus 27.6 ± 2.3 kg/m2;
p = 0.19), and stone size (7.2 ± 1.5 versus 7.3 ± 1.7 mm;
p = 0.70), respectively. Furthermore, there was no
significant difference in the outcome parameters between
both groups in terms of operative time (42.4 ± 8.3 versus
40.3 ± 6.5 min; p = 0.08), stone free rate (93.2% versus
95%; p = 0.06), and overall complications (12.2% versus
8.75%; p = 0.08), respectively. There was significant
difference between both techniques in terms of fluoroscopy
time (p < 0.001). However, 6 (7.5%) fluoroless-URS
cases necessitated the use of fluoroscopy intraoperatively.
Conclusion: Ureteroscopic management of distal ureteral
stones using fluoroless-URS technique could be feasible
and safe, without radiation exposure for patients and
medical personnel. However, fluoroscopy should always
be available during fluoroless-URS.
GOMAA R, SOLIMAN T, AHMED S, NOURELDIN
YA. Fluoroless ureteroscopy for definitive
management of distal ureteral calculi: randomized
controlled trial. Can J Urol 2018;25(1):0000-0000.
Introduction: To assess the conversion rate during
fluoroless-ureteroscopy (URS) and evaluate the feasibility,
safety, and efficacy of fluoroless-URS as a definitive
management of distal ureteral calculi.
Material and methods: Between May 2013 and August
2015, patients with radio-opaque distal ureteral calculi
of ≤ 1 cm in size were randomized to undergo fluoroless-
URS or standard URS. Patients with previous ureteral
surgery, ureteral kinking, ureteral stricture, single kidney,
additional proximal ureteral or renal calculi, uncontrolled
coagulopathy, and/or congenital anomalies of the urinary
tract were excluded. Patients’ demographics, stone
characteristics, operative data, stone free status, and
complications were compared between both groups.
Results: Seventy-four cases in the fluoroless-URS
group were compared with 80 cases in the standard-URS
group. There was no significant difference in the baseline
characteristics between both groups in terms of the mean
patient’s age (28.8 ± 13.3 versus 29.5 ± 14.6 years;
p = 0.76), body mass index (28.2 ± 33 versus 27.6 ± 2.3 kg/m2;
p = 0.19), and stone size (7.2 ± 1.5 versus 7.3 ± 1.7 mm;
p = 0.70), respectively. Furthermore, there was no
significant difference in the outcome parameters between
both groups in terms of operative time (42.4 ± 8.3 versus
40.3 ± 6.5 min; p = 0.08), stone free rate (93.2% versus
95%; p = 0.06), and overall complications (12.2% versus
8.75%; p = 0.08), respectively. There was significant
difference between both techniques in terms of fluoroscopy
time (p < 0.001). However, 6 (7.5%) fluoroless-URS
cases necessitated the use of fluoroscopy intraoperatively.
Conclusion: Ureteroscopic management of distal ureteral
stones using fluoroless-URS technique could be feasible
and safe, without radiation exposure for patients and
medical personnel. However, fluoroscopy should always
be available during fluoroless-URS.