Early complications of diagnostic and therapeutic ureteroscopy

Abstract EN

Objective : The aim of this study is to report early complications of diagnostic and therapeutic ureteroscopy and to grade each complication according to modified Clavien classification system (MCCS).

Materials and Methods: Through a prospective study conducted from March to September 2017, all patients who underwent diagnostic and therapeutic semirigid ureteroscopy were evaluated.

The procedure was performed by different surgeons.

The recording data included patient demographics, ureteroscopy site (left, right, or bilateral), aim of ureteroscopy (diagnostic or therapeutic), operative time, additional intervention, stone‑free rate, double J stent placement, and complications which were graded according to the modefied clavien classification system with their management.

Results: One hundred and fifty patients were included in the study.

The average age was 39.9 years and male‑to‑female ratio 2.3 / 1.

The number of patients who underwent right, left, and bilateral ureteroscopy was 74 (49.3 % ), 64 (42.3 % ), and 12 (8 % ), respectively, so the overall number of ureteroscopy procedures was 162.

Diagnostic ureteroscopy was done in 20 (13.3 % ) patients and therapeutic ureteroscopy in 130 (87.7 % ).

Complications occurred in 37.3 % of patients.

According to MCCS, Grade I, II, IIIa, IIIb, IVa, IVb, and V complications were detected in 40 (26.6 % ), 6 (4 % ), 10 (6.7 % ), 14 (9.3), 0 (0.0 % ), 2 (1.3 % ), and 0 (0.0 % ) of cases, respectively.

Conclusion: Ureteroscopy becomes the prevailing procedure for different ureteral pathologies mainly stones with a good safety and efficacy.

It is important to adopt a precise classification system for reporting the complications of ureteroscopy.

Most of the complications are of low grade and they are amenable to conservative management.

The complications of ureteroscopy will continue to decline as the ureteroscopic technology evolved.