Efficacy And Safety Of Same-session Flexible Ureteroscopic Lithotripsy For Unilateral Upper Urinary Tract Calculi 2 Cm Or Smaller

Objective: To evaluate the efficacy and safety of same-session flexible ureteroscopy(f-URS)with holmium laser without preoperative ureteral stent placement for the treatment of unilateral upper urinary tract calculi 2 cm or smaller in comparison with staged flexible ureteroscopy with preoperative ureteral stent placement.Methods: The clinical data were retrospectively analyzed for 240 patients undergoing unilateral f-URS with holmium laser for unilateral renal and proximal urinary calculi 2 cm or smaller in our department between January,2016 to June,2017.Of these patients,120 received same-session unilateral f-URS surgery without a preexistent ureteral stent and the other 120 underwent staged surgery with preoperative ureteral stent placement.The operation time,the success rate of ureteral access sheath placement and lithotripsy,postoperative hospital stay,postoperative complication rate,and the stone-free rate(SFR)at 1 month after the operation were compared between the two groups.Results: No significant differences were found between the 2 groupsin the operation time,success rate of ureteral access sheath placement,success rate of lithotripsy,postoperative hospital stay,postoperative complication rate,or the stone-free rate(SFR)at 1 month postoperative(P> 0.05).The patients receiving same-session ureteroscopy without a preexistent ureteral stent,however,had fewer hospital admissions with lower hospital expenditure than those receiving staged surgery with preoperative ureteral stent placement.Conclusion: Same-session flexible ureteroscopy without a preexistent ureteral stent and staged surgery with preoperative ureteral stent placement have similar efficacy and safety for treatment of unilateral upper urinary tract calculi 2 cm or smaller.