Elsevier

Urology

Volume 111, January 2018, Pages 44-47
Urology

Endourology and Stones
The Application of Suctioning Flexible Ureteroscopy With Intelligent Pressure Control in Treating Upper Urinary Tract Calculi on Patients With a Solitary Kidney

https://doi.org/10.1016/j.urology.2017.07.042Get rights and content

Objective

To investigate the usage of intelligently pressure-controlled flexible ureteroscopy (URS) in managing upper urinary tract calculi in patients with a solitary kidney.

Methods

Forty patients with a solitary kidney and upper urinary tract calculus were included in this study. All the patients underwent suctioning URS with intelligent control of renal pelvic pressure by connecting pressure-measuring suctioning ureteral access sheath to an irrigation and suctioning platform. Treatment outcome and perioperative data were collected.

Results

The mean operative time was 25.2 ± 14.5 minutes. The mean hospital stay was 4.7 ± 1.4 days. The stone-free rate at 4 weeks after surgery was 87.5%, and it was 92.5% at 12 weeks after surgery. Two patients (5%) experienced complications of fever postoperatively. There were no complications of elevated serum creatinine, severe bleeding, sepsis, stone street, ureteral mucosa stripping, and ureteral stenosis.

Conclusion

It is safe and efficient to use the intelligently pressure-controlled flexible URS in treating upper urinary tract calculi for patients with a solitary kidney with advantages of high lithotripsy efficacy and low complication rate.

Section snippets

General Data

From November 2013 to August 2015, 40 patients with a solitary kidney and upper urinary tract calculus were included in this study with 25 males and 15 females. The ages ranged from 34 to 73 years old with an average age of 50 ± 3.5 years old. Eight patients had a congenital solitary kidney, 12 patients had a solitary kidney because of contralateral nephrectomy, and 20 patients had a solitary kidney because of atrophic and nonfunctional contralateral kidney. Thirteen patients had lower renal

General Data

As shown in Table 1, 40 patients were included in this study, 62.96% males and 37.04% females. The stone sizes ranged from 0.9 to 3.0 cm. There were stones in the lower renal calyx, middle and upper renal calyces, renal pelvis, and upper segment of ureter. There were 73.15% patients who did not have hydronephrosis preoperatively, whereas the other 26.85% patients had hydronephrosis at various degrees. There were 17.6% patients who had preoperative history of SWL.

Outcome of Treatment

As shown in Table 2, on 29 of

Discussion

The management for upper urinary tract calculi has been a clinical dilemma because of its difficulty. Traditional open surgery could cause significant damage to the kidney and is of high risk. The other option of SWL could lead to renal atrophy after being performed for multiple times. There were reported good outcomes by using PCNL, but this is also a high-risk procedure and it is difficult to manage its residual stones.8, 9

In recent years, there were good outcomes achieved by using flexible

Conclusion

Our study showed that it was safe and efficient to use the intelligently pressure-controlled flexible URS in treating upper urinary tract calculi for patients with a solitary kidney with advantages of high lithotripsy efficacy and low complication rate.

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Jianrong Huang, Donghua Xie, Ruiping Xiong, and Xiaolin Deng contributed equally.

Financial Disclosure: The authors declare that they have no relevant financial interests.

Funding Support: This study was funded by the following funds: (1) Jiangxi Provincial Science and Technology Agency major science and technology projects (20152ACG70009); (2) Science and Technology Bureau of Ganzhou City Major scientific Funds ([2014]131); and (3) Ganzhou Science and Technology Bureau Guiding Science and Technology Plan Project (GZ2015ZSF182).

Consent: Written informed consent was obtained from the patients for publication of this report and any accompanying images. Copies of the written consent are available for review by the Editor of the journal.

Ethical Standard: Ethical and regulatory approvals were sought and obtained from the Affiliated Ganzhou Hospital of Nanchang University.

Author Contribution: Protocol/project development: Song, Xie, Huang J. Data collection or management: Huang J, Xiong, Deng, Song, Huang C, Fan, Zhang, Peng, Zeng, Qin, Zeng. Data analysis: Xie, Deng, Xiong. Manuscript writing/editing: Xie, Deng, Huang J, Xiong, Song, Huang C.

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