Role of emergency ureteroscopy in the management of ureteric stones: analysis of 394 cases

BJU International - Tập 115 Số 6 - Trang 946-950 - 2015
Kamran Zargar‐Shoshtari1, William B. Anderson1, Michael Rice1
1Department of Urology, Auckland City Hospital, Auckland, New Zealand

Tóm tắt

Objective

To analyse the outcomes of emergency ureteroscopy (URS) cases performed in Auckland City Hospital.

Methods

We conducted a retrospective review of all emergency URS procedures performed at Auckland City Hospital between 1 January 2010 and 31 December 2011. Data on patients, stones and procedures were collected and analysed. Emergency URS failure was defined as fragments >3 mm or the need for a repeat procedure.

Results

A total of 499 URS procedures were identified. Of these 394 (79%) were emergency procedures. The mean (sd; range) patient age was 48 (16; 13–88) years. In all, 83% of emergency URS cases had an American Society of Anesthesiologists (ASA) score of 1 or 2, 25% of stones were >9 mm, with a mean (sd) size of 8 (4) mm, and 285 procedures (72%) were successful. These patients were younger (47 vs 51 years), were more likely to have an ASA score of 1 (103 patients in the successful treatment group vs 26 in the failed treatment group), had smaller stones (7 vs 9 mm) and were more likely to have distal stones (P < 0.05). A total of 20 complications (5%) were recorded including six false passages and three mucosal injuries, one of which required radiological intervention, and 50 patients (13%) re‐presented, for pain (76%), bleeding (10%) or infection (14%).

Conclusion

We showed that emergency URS is a feasible approach for the routine management of acute ureteric colic with a low complications rate. A subgroup of younger, healthier patients may benefit the most from the procedure.

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