AUA 2019: Emergency Versus Elective Ureteroscopy

Chicago, IL ( Most patients with urinary tract stones suffer severely from renal colic pain. This pain is often alleviated by means of elective ureteroscopy, however many studies suggest that emergency ureteroscopies may be a more sensible means of pain relief. Vigen Malkhasyan from Moscow’s Russian Foundation presents a study evaluating the efficacy and safety of the emergency versus elective ureteroscopy. 

For this retrospective study, Malkhasyan and his co-authors analyzed their hospital databases within a 13-year period, finding 4031 cases, 838 emergency and 3193 elective ureteroscopy patients available for analysis. These groups were compared based on positive margins, defined by successful kidney obstruction or stone extraction, partial margins, URS failure, the inability to access and visualize stones, and NB proximal migration.

It was observed was that renal colic sites were predominantly in the lower part of the ureter, and the full positive effect was found in 89.0% and 88.3%, and partial positive effect of 5.0% and 6.6% in elective and emergency ureteroscopies, respectively. URS failure was observed in 4.9% of elective and 3.3% emergency patients, with no statistically significant difference. NB proximal migration showed a 1% difference between the groups.

Malkhasyan concluded his presentation declaring that based on their analysis, emergency ureteroscopy is not only feasible but a safe and beneficial method of caring for noninfective ureteric calculi patients. He emphasizes that this technique fosters pain relief and complete stone removal. Malkhasyan suggests that future RCT ought to be put in place to further reaffirm the benefits of this standard of care.

Presented by: Vigen Malkhasyan, Moscow’s Russian Foundation
Co-authors: George Kasyan, Malika Dzhuraeva, Igor Semenyakin, Dmitriy Pushkar, and Vadim Ivanov
Affiliation: Moscow, Russian Federation

Written by: Aleesa Chavez, (Department of Urology, University of California, Irvine) at the American Urological Association's 2019 Annual Meeting (AUA 2019), May 3 – 6, 2019 in Chicago, Illinois