Flexible ureterorenoscopy for upper urinary tract treatment using new 7.5 F 270 degree deflectable ureteroscope: Siriraj Hospital early experience.

ABSTRACT

Objective: To evaluate the efficacy and report our experience of using a flexible ureterorenoscopy in the diagnosis and therapy for upper urinary tract disease. Methods: Between September 2005 and June 2008, 21 upper urinary tract procedures were performed with 7.5 F actively deflectable, flexible ureteroscope. Of these 13 were for diagnostic reasons and eight for therapeutic purposes. A retrospective data of these procedures was collected. The indication, diagnostic or therapeutic procedure, operative time, success rate and postoperative course were analyzed. Results: The procedures were performed in 21 patients (mean age 66.71 years; range, 47-85 years; 11 procedures in males and 10 procedures in females). The indications were lateralizing essential hematuria (2), hematuria with upper tract radiolucent lesions (11), upper tract lesions without hematuria (3) and stones (5). In the diagnostic group, the mean operative time was 50 min (range 15-120). The procedure was completed successfully in all patients. The most common endoscopic finding was urothelial carcinoma in hematuria with upper tract lesions (9/11). In the therapeutic group (stone removal five, tumor fulguration three), the mean operative time was 83.12 min (range 30-160). The success rate of these therapeutic procedures was 62.5% (5/8). There was no intra and postoperative major complication. With an average follow up of 14 months (range 1-33), no patient had a late complication, such as ureteral stricture. The flexible ureteroscope did not need repair during this study. Conclusion: Flexible ureterorenoscopy is an effective and minimally invasive diagnostic and therapeutic tool for upper urinary tract disease.