Flexible Ureteroscopy At Least As Effective as ESWL for Large Stones

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Flexible ureteroscopy and lasertripsy (FURSL) for treating renal stones larger than 1 cm in diameter is associated with high success rates, data show.

The finding comes from a study of 88 patients conducted by investigators at Ninewells Hospital in Dundee, U.K. They noted that European Association of Urology (EAU) guidelines recommend that renal stones less than 20 mm in diameter should be treated with extracorporeal shock wave lithotripsy (ESWL), but pointed out that evidence suggests that success rates are significantly affected by stone position, renal anatomy, and stone size.

EAU guidelines acknowledge this, they noted, but suggest that ureteroscopy should be performed only when ESWL is contraindicated.

The researchers treated the 88 patients with FURSL for single or multiple renal stones at least 1 cm in diameter. Of these patients, 76 (86.4%) were stone free after a mean follow-up period of 15 months. The mean number of treated stones per case was 2.76 and the mean stone burden was 19.3 mm. Findings were presented at the 24th Annual EAU Congress in Stockholm.

In 56 patients, they performed FURSL on multiple calculi, rendering 46 of patients (82.1%) stone free. In addition, the researchers performed bilateral procedures in 18 patients, rending 17 (94.4%) stone free. FURSL treatment of stones greater than 20 mm in diameter was associated with a stone-free rate of 90%.

Lower calyceal stones were successfully cleared in 22 of 30 cases (73.3%). The investigators performed seven repeat procedures, with subsequent stone-free status achieved in all but one case. The researchers concluded that FURSL is at least as effective as ESWL for renal calculi greater than 1 cm in diameter.

Flexible ureteroscopy and lasertripsy (FURSL) for treating renal stones larger than 1 cm in diameter is associated with high success rates, data show.

The finding comes from a study of 88 patients conducted by investigators at Ninewells Hospital in Dundee, U.K. They noted that European Association of Urology (EAU) guidelines recommend that renal stones less than 20 mm in diameter should be treated with extracorporeal shock wave lithotripsy (ESWL), but pointed out that evidence suggests that success rates are significantly affected by stone position, renal anatomy, and stone size.

EAU guidelines acknowledge this, they noted, but suggest that ureteroscopy should be performed only when ESWL is contraindicated.

The researchers treated the 88 patients with FURSL for single or multiple renal stones at least 1 cm in diameter. Of these patients, 76 (86.4%) were stone free after a mean follow-up period of 15 months. The mean number of treated stones per case was 2.76 and the mean stone burden was 19.3 mm. Findings were presented at the 24th Annual EAU Congress in Stockholm.

In 56 patients, they performed FURSL on multiple calculi, rendering 46 of patients (82.1%) stone free. In addition, the researchers performed bilateral procedures in 18 patients, rending 17 (94.4%) stone free. FURSL treatment of stones greater than 20 mm in diameter was associated with a stone-free rate of 90%.

Lower calyceal stones were successfully cleared in 22 of 30 cases (73.3%). The investigators performed seven repeat procedures, with subsequent stone-free status achieved in all but one case. The researchers concluded that FURSL is at least as effective as ESWL for renal calculi greater than 1 cm in diameter.

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