[Safety and feasibility of outpatient flexible ureteroscopy for urinary stones: A retrospective single-center study].

AIM

Management of urolithiasis has changed over the past decades. Outpatient surgery has become a major issue for healthcare systems. The aim of this study was to assess the feasibility of outpatient flexible ureteroscopy.

METHODS

A single-center retrospective study has been conducted including all patients who underwent an outpatient flexible ureteroscopy between January 2012 and December 2013. Failure of outpatient management was defined as length of hospital stay>12 hours or readmission within 48 hours after discharge. Univariate analysis was performed to seek for predictors of failure of outpatient management.

RESULTS

One hundred and fifty-seven patients who underwent a total of 174 procedures were included. They were mostly men (57.5 %), with a mean body mass index of 25.2kg/m (±4.3). The stones were mostly unique (64.3 %), with a mean size of 14.2mm (±11.2). Eighty patients had a double J stent preoperatively (46.5 %), and mean operative time was 64.2 minutes (±34.1). An ureteral access sheath was used in 39 procedures (22.4 %). A double J stent was left postoperatively in 103 patients (59.1 %). In total, 165 procedures (94.8 %) were performed successfully as outpatient surgery. On postoperative imaging, the stone-free rate was 69.5 %. Postoperative complications occurred in 3.4 % of cases and were mostly minor (i.e. Clavien 1-2; 83.3 %). Predictive factors of failed outpatient management were male gender (P=0.04), BMI (P=0.03), and anticoagulants intake (P=0.003).

CONCLUSION

Outpatient flexible ureteroscopy for urinary stones is feasible and its low failure and complications rate may allow a wider spread of its use.

LEVEL OF EVIDENCE