ABSTRACT
Objective: To assess the outcome of simultaneous bilateral endoscopic surgery in the management of renal and ureteral lithiasis. Patients and Methods: Five patients were reviewed retrospectively. Two patients underwent bilateral simultaneous ureteroscopy for ureteral calculi; on two others bilateral simultaneous PCNL was performed in treatment of renal lithiasis. In one patient bilateral simultaneous ureteroscopic extraction of ureteral calculi was done prior to bilateral PCNL for renal lithiasis. Ureteral stenting was performed in all patients. In those patients who underwent PCNL a nephrostomy was done. Results: In all patients who had undergone PCNL the outcome was considered satisfactory. One of them had residual stones of less than 3 mm in both kidneys; which required only surveillance. Another patient had residual calculi in both kidneys with a diameter of 6 and 7 mm respectively. In this patient a complementary ESWL was necessary. The last patient was stonefree after the procedure. The results of simultaneous bilateral ureteroscopy assessed one month after the procedure with a plain abdominal film and renal ultrasonography were excellent since all patients were free of stones. An important haemorrhage complicating a PCNL was treated by embolization. Conclusion: Simultaneous bilateral endoscopic surgery of the upper urinary tract is a good alternative after failure of ESWL for renal and ureteral lithiasis. The risks and complications of the procedure are comparable to those of endoscopic unilateral surgery of the upper tract
