Flexible versus Rigid ureteroscopy in the management of proximal ureteric stones

Abstract EN

Objectives : our study aims at researching the operative outcomes after using flexible ureteroscopy (F.URS) versus rigid ureteroscopy (R.URS) lithotripsy for the management of patients with symptomatic proximal ureteric stones (pus).

materials and methods : the (390) patients aged between 18 and 67 who underwent URS (f.

vs.

r.) for upper ureteric stones (from June 2017 to June 2018) at prince Hussein urology center were found eligible to be enclosed during this retrospective study.

patients were divided into two equal groups with regard to the number of examined patients, (F.URS) ; the number of patients for group-1 was 195, (R.URS); the number of patients for group-2 was 195 as well.

a number of chosen "demographic characteristics" and "stones sizes" were collected at baseline; in addition to that, the categorical data were analyzed by SPSS version / 24.

the follow up period was estimated for at least 3 months.

the operative time was also calculated; the intraoperative and the post-operative complications were expressed by the "clavien-dindo" classification system.

results : it was found that of the total number of the 390 patients, no statistical significant differences at baseline were found regarding ages, gender, stone sizes, laterality and opacity of the stones when both groups' results were compared: (the stone sizes p value was estimated at 0.36), (the laterality p value was estimated at 0.14) and (the opacity p value was estimated at 0.98).

the mean operative time was shorter in the (R.URS) group in comparison to the (F.URS) group (40.9± 16.4, 52±13.81, p= 0.018).

the (F.URS) group had a higher proportion for the stone clearance rate (p =0.007); the perioperative complication rate was not statistically different (p= > 0.05).

conclusion : the operative time was less in (R.URS) and the stone clearance rate was considerably higher in (F.URS).

therefore, it was concluded that (R.URS) was less successful in the stone clearance rate, and hence should be used only as a second option as regards F.URS which must be used as the first viable option.