Premium
Role of emergency ureteroscopy in the management of ureteric stones: analysis of 394 cases
Author(s) -
ZargarShoshtari Kamran,
Anderson William,
Rice Michael
Publication year - 2015
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12841
Subject(s) - medicine , ureteroscopy , emergency department , renal colic , radiological weapon , surgery , ureter , alternative medicine , pathology , psychiatry
Objective To analyse the outcomes of emergency ureteroscopy ( URS ) cases performed in A uckland City Hospital. Methods We conducted a retrospective review of all emergency URS procedures performed at A uckland City Hospital between 1 J anuary 2010 and 31 D ecember 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.