Süer Evren, Gülpinar Ömer, Özcan Cihat, Göğüş Çağatay, Kerimov Seymur, Şafak Mut
Department of Urology, University of Ankara, Ankara, Turkey.
Korean J Urol. 2015 Feb;56(2):138-42. doi: 10.4111/kju.2015.56.2.138. Epub 2015 Feb 2.
To evaluate the outcomes of rigid ureterorenoscopy (URS) for renal pelvic stones (RPS) sized 1 to 2 cm and to determine the predictive factors for the requirement for flexible URS (F-URS) when rigid URS fails.
A total of 88 patients were included into the study. In 48 patients, the RPS were totally fragmented with rigid URS and F-URS was not required (group 1). In 40 patients, rigid URS was not able to access the renal pelvis or fragmentation of the stones was not completed owing to stone position or displacement and F-URS was utilized for retrograde intrarenal surgery (RIRS) (group 2). The predictive factors for F-URS requirement during RIRS for RPS were evaluated. Both groups were compared regarding age, height, sex, body mass index, stone size, stone opacity, hydronephrosis, and previous treatments.
The mean patient age was 48.6±16.5 years and the mean follow-period was 39±11.5 weeks. The overall stone-free rate in the study population was 85% (75 patients). In groups 1 and 2, the overall stone-free rates were 83% (40 patients) and 87% (35 patients), respectively (p>0.05). The independent predictors of requirement for F-URS during RIRS were male gender, patient height, and higher degree of hydronephrosis.
Rigid URS can be utilized in selected patients for the fragmentation of RPS sized 1 to 2 cm with outcomes similar to that of F-URS. In case of failure of rigid URS, F-URS can be performed successfully in this group of patients.
评估硬性输尿管肾镜检查（URS）治疗直径1至2厘米肾盂结石（RPS）的效果，并确定硬性URS失败时需要软性URS（F-URS）的预测因素。
共纳入88例患者。48例患者中，RPS通过硬性URS完全碎裂，无需F-URS（第1组）。40例患者中，由于结石位置或移位，硬性URS无法进入肾盂或结石碎裂未完成，因此使用F-URS进行逆行肾内手术（RIRS）（第2组）。评估了RPS在RIRS期间需要F-URS的预测因素。比较两组患者的年龄、身高、性别、体重指数、结石大小、结石透光度、肾积水及既往治疗情况。
患者平均年龄为48.6±16.5岁，平均随访期为39±11.5周。研究人群的总体无石率为85%（75例患者）。第1组和第2组的总体无石率分别为83%（40例患者）和87%（35例患者）（p>0.05）。RIRS期间需要F-URS的独立预测因素为男性、患者身高和更高程度的肾积水。
对于部分患者，硬性URS可用于碎裂直径1至2厘米的RPS，效果与F-URS相似。若硬性URS失败，在这类患者中可成功进行F-URS。
