The aim of this study is to assess the effectiveness, safety and reproducibility of the micro - ureteroscopy (m - URS) in the treatment of pelvic ureter distal ureteral stones in women.
A multicenter, prospective, observational study was designed and conducted between March and December 2015. We included women having at least one stone in the distal pelvic ureter and being a candidate for surgical treatment employing the 4.85 French sheath of Micro-Perc®. Patients with clinical criteria and/or laboratory analysis indicating sepsis, or coagulation alteration were excluded.
39 women were operated in 8 hospitals. The profile of the patients was fairly homogeneous among hospitals. Only differences were found in age, preoperative stent and the result of the previous urine culture. Immediate stone-free status was achieved in 88.2% and 100% seven days after the procedure. 97.4 % of patients did not present any complication in the postoperative period, with only one case with complication Clavien II. PULS scale(Post-Ureteroscopic Lesion Scale) scale in 76.9 % of patients did not show any injury, 20.5% had lesions grade 1 and grade 2 lesions 2.6 %. As for the reproducibility of micro - ureteroscopy between hospitals, statistical analysis of the results showed statistically significant differences between all the centers participating in the study.
Micro-ureteroscopy is an effective, safe and reproducible technique that minimizes surgical aggression to the ureteral anatomy. Satisfactory and comparable results to "conventional" ureteroscopy results that wereare comparable to "conventional" ureteroscopy wereare obtained in the treatment of pelvic distal ureteral stones in women, though clinical trials are needed. The reduction of the ureteral damage may reduce secondary procedures and increase the cost-effectiveness of the procedure.
Journal of endourology / Endourological Society. 2016 Aug 26 [Epub ahead of print]
Juan Pablo Caballero, Juan Antonio Galán, Daniel Pérez-Fentes, Alberto Budia, Marcos Cepeda, Jose Luis Palmero, Ramón Cansino, Pablo Caballero, Gaspar Ibarluzea
Hospital del Vinalopó, Urology , Tonico Sansano mora nº 14 , Elche, Alicante, Spain , 03992 ; ., Hospital del Vinalopo. , Urology , Tonico Sansano Mora, 14 , Elche, Alicante, Spain , 03540 ; ., Santiago de Compostela Universitary Hospital, Urology, Santiago de Compostela, Spain ; ., University Hospital La Fe, Urology, Valencia, Spain ; ., Rio Hortega Universitary Hospital, Valladolid, Spain ; ., LA RIBERA UNIVERSITY HOSPITAL, SWL & ENDOUROLOGY DEPARTMENT , Carretera Corbera s/n Km1 , C/ SANG, 3, 1-1 , ALZIRA, VALENCIA, Spain , 46600 ; ., Hospital La Paz, Urology , Av/ Castellana 261 , Madrid, Spain , 28046 ; ., University of Alicante, Alicante, Spain, Department of Community Nursing, Preventive Medicine and Public Health and History of Science Health. Faculty of Health Sciences, Alicante, Outside U.S./Canada, Spain ; ., IMQ Zorrotzaurre Clinic, Urology, Bilbao, Spain ; .