Ultrasound Following Ureteroscopy Justified

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Postoperative silent ureteral obstruction found in about 5% of patients.

SHANGHAI—New findings may support the routine use of renal ultrasound examinations following ureteroscopy.

David S. Wang, MD, associate professor of urology at Boston University Medical Center, and his colleagues reviewed data on 289 patients who underwent ureteroscopy and had a follow-up renal ultrasound examination an average of 54 days postoperatively. Of these, 14 (4.8%) had asymptomatic ureteral obstruction and three of them required additional procedures to clear the obstruction.

The investigators believe routine renal ultrasound should be required after every ureteroscopy to prevent renal function deterioration in cases of undetected hydronephrosis.

“As a department, we now make sure that all patients get proper follow-up with renal ultrasound after ureteroscopy and make every attempt to contact patients who do not keep these follow-up appointments,” Dr. Wang said. He reported study findings at the 2008 World Congress of Endourology.

Alberto Breda, MD, a visiting assistant professor in minimally invasive surgery at the University of California at Los Angeles who has conducted research in this area, says his department takes the same approach.

“We routinely perform ultrasound four weeks after stent removal in all our [ureteroscopy patients],” Dr. Breda said. “The reason for this is, as the poster authors found, a small percentage of patients could develop silent postoperative obstruction that could potentially damage the kidney.”

Dr. Breda noted, however, that he is not certain the cost of routine follow-up ultrasound examinations in all patients is justified, since so few patients in the study by Dr. Wang's team (1%) required additional procedures.

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