Effectiveness of Second-look Flexible Ureteroscopy to Achieve A True Stone-Free Status in Retrograde Intrarenal Surgery
Objective:Residual stone fragments remain a challenging topic for urologists following retrograde intrarenal surgery (RIRS). This study aimed to investigate the effectiveness of second-look flexible ureteroscopy (URS) to achieve a true stone-free status and decrease stone-related events.Materials an...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Galenos Yayinevi
2022-03-01
|
| Series: | Journal of Urological Surgery |
| Subjects: | |
| Online Access: |
http://jurolsurgery.org/archives/archive-detail/article-preview/effectiveness-of-second-look-flexible-ureteroscopy/51029
|
| _version_ | 1828022468738023424 |
|---|---|
| author | Oğuz Özden Cebeci Tayyar Alp Özkan Mustafa Savaş Yalçın Özdal Dillioğlugil İbrahim Çevik |
| author_facet | Oğuz Özden Cebeci Tayyar Alp Özkan Mustafa Savaş Yalçın Özdal Dillioğlugil İbrahim Çevik |
| author_sort | Oğuz Özden Cebeci |
| collection | DOAJ |
| description | Objective:Residual stone fragments remain a challenging topic for urologists following retrograde intrarenal surgery (RIRS). This study aimed to investigate the effectiveness of second-look flexible ureteroscopy (URS) to achieve a true stone-free status and decrease stone-related events.Materials and Methods:The study included 176 consecutive patients treated with RIRS for kidney stones between October 2013 and December 2017. Patients were divided into two groups. Group 1 included patients who underwent only one session of RIRS (n=51) and group 2 included patients who undergo a second-look flexible URS after RIRS (n=125). Both groups were compared for stone-free rates and potential risk factors associated with stone-related events. Stone-related events were defined as urinary infection, renal colic, stone enlargement, and any additional intervention with shock wave lithotripsy or reoperation.Results:Stone-free rate after RIRS for groups 1 and 2 were 37.25% (n=19/51) and 40.8% (n=51/125), respectively. The stone-free rates improved to 93.6% (n=117/125) in group 2 after the second-look flexible URS. The multivariable analysis revealed that type of intervention, stone size, and body mass index were independent prognostic factors for stone-related events. When group 2 was taken as a reference, the odds ratio for stone-related events was 8.48 (95% confidence interval: 2.95-24.42) in group 1.Conclusion:Second-look flexible ureterorenoscopy increased the stone-free rates and diminished the number of stone-related events. We argue that performing second-look flexible ureterorenoscopy in the early period following RIRS in the presence or suspicion of residual stone fragments provides better treatment results. |
| first_indexed | 2024-04-10T12:09:49Z |
| format | Article |
| id | doaj.art-0bd725932d404effb6dacf9f50e5735b |
| institution | Directory Open Access Journal |
| issn | 2148-9580 |
| language | English |
| last_indexed | 2024-04-10T12:09:49Z |
| publishDate | 2022-03-01 |
| publisher | Galenos Yayinevi |
| record_format | Article |
| series | Journal of Urological Surgery |
| spelling | doaj.art-0bd725932d404effb6dacf9f50e5735b2023-02-15T16:16:02ZengGalenos YayineviJournal of Urological Surgery2148-95802022-03-0191404610.4274/jus.galenos.2021.2021.009213049054Effectiveness of Second-look Flexible Ureteroscopy to Achieve A True Stone-Free Status in Retrograde Intrarenal SurgeryOğuz Özden Cebeci0Tayyar Alp Özkan1Mustafa Savaş Yalçın2Özdal Dillioğlugil3İbrahim Çevik4 University of Health Sciences Turkiye, Kocaeli Derince Training and Research Hospital, Clinic of Urology, Kocaeli, Turkiye Acıbadem Kocaeli Hospital, Clinic of Urology, Kocaeli, Turkiye Private Dr. Nazif Bağrıaçık Kadıköy Hospital, Clinic of Urology, İstanbul, Turkiye Kocaeli University Faculty of Medicine, Department of Urology, Kocaeli, Turkiye Private Dr. Nazif Bağrıaçık Kadıköy Hospital, Clinic of Urology, İstanbul, Turkiye Objective:Residual stone fragments remain a challenging topic for urologists following retrograde intrarenal surgery (RIRS). This study aimed to investigate the effectiveness of second-look flexible ureteroscopy (URS) to achieve a true stone-free status and decrease stone-related events.Materials and Methods:The study included 176 consecutive patients treated with RIRS for kidney stones between October 2013 and December 2017. Patients were divided into two groups. Group 1 included patients who underwent only one session of RIRS (n=51) and group 2 included patients who undergo a second-look flexible URS after RIRS (n=125). Both groups were compared for stone-free rates and potential risk factors associated with stone-related events. Stone-related events were defined as urinary infection, renal colic, stone enlargement, and any additional intervention with shock wave lithotripsy or reoperation.Results:Stone-free rate after RIRS for groups 1 and 2 were 37.25% (n=19/51) and 40.8% (n=51/125), respectively. The stone-free rates improved to 93.6% (n=117/125) in group 2 after the second-look flexible URS. The multivariable analysis revealed that type of intervention, stone size, and body mass index were independent prognostic factors for stone-related events. When group 2 was taken as a reference, the odds ratio for stone-related events was 8.48 (95% confidence interval: 2.95-24.42) in group 1.Conclusion:Second-look flexible ureterorenoscopy increased the stone-free rates and diminished the number of stone-related events. We argue that performing second-look flexible ureterorenoscopy in the early period following RIRS in the presence or suspicion of residual stone fragments provides better treatment results. http://jurolsurgery.org/archives/archive-detail/article-preview/effectiveness-of-second-look-flexible-ureteroscopy/51029 retrograde intrarenal surgerysecond-look flexible ureteroscopystone-free rateresidual stone fragmentsstone-related event |
| spellingShingle | Oğuz Özden Cebeci Tayyar Alp Özkan Mustafa Savaş Yalçın Özdal Dillioğlugil İbrahim Çevik Effectiveness of Second-look Flexible Ureteroscopy to Achieve A True Stone-Free Status in Retrograde Intrarenal Surgery Journal of Urological Surgery retrograde intrarenal surgery second-look flexible ureteroscopy stone-free rate residual stone fragments stone-related event |
| title | Effectiveness of Second-look Flexible Ureteroscopy to Achieve A True Stone-Free Status in Retrograde Intrarenal Surgery |
| title_full | Effectiveness of Second-look Flexible Ureteroscopy to Achieve A True Stone-Free Status in Retrograde Intrarenal Surgery |
| title_fullStr | Effectiveness of Second-look Flexible Ureteroscopy to Achieve A True Stone-Free Status in Retrograde Intrarenal Surgery |
| title_full_unstemmed | Effectiveness of Second-look Flexible Ureteroscopy to Achieve A True Stone-Free Status in Retrograde Intrarenal Surgery |
| title_short | Effectiveness of Second-look Flexible Ureteroscopy to Achieve A True Stone-Free Status in Retrograde Intrarenal Surgery |
| title_sort | effectiveness of second look flexible ureteroscopy to achieve a true stone free status in retrograde intrarenal surgery |
| topic | retrograde intrarenal surgery second-look flexible ureteroscopy stone-free rate residual stone fragments stone-related event |
| url |
http://jurolsurgery.org/archives/archive-detail/article-preview/effectiveness-of-second-look-flexible-ureteroscopy/51029
|
| work_keys_str_mv | AT oguzozdencebeci effectivenessofsecondlookflexibleureteroscopytoachieveatruestonefreestatusinretrogradeintrarenalsurgery AT tayyaralpozkan effectivenessofsecondlookflexibleureteroscopytoachieveatruestonefreestatusinretrogradeintrarenalsurgery AT mustafasavasyalcın effectivenessofsecondlookflexibleureteroscopytoachieveatruestonefreestatusinretrogradeintrarenalsurgery AT ozdaldillioglugil effectivenessofsecondlookflexibleureteroscopytoachieveatruestonefreestatusinretrogradeintrarenalsurgery AT ibrahimcevik effectivenessofsecondlookflexibleureteroscopytoachieveatruestonefreestatusinretrogradeintrarenalsurgery |