URETERAL STONES: IS IT POSSIBLE A LOW-COST TREATMENT?: A SINGLE HIGH FLOW CENTER EXPERIENCE
Urolithiasis is a common and costly disease. URS is the most commonly advocated treatment for patients with ureteral calculi with a stone-free rate higher than 90% after a single treatment. In 2007 the EAU Guideline recommended that for ureteral stones requiring removal, because up to 98% of ureteral calculi <5mm in diameter are likely to pass spontaneously, both SWL and URS are acceptable first-line treatments in healthy non-pregnant adults who have unilateral calculi.
Complete clearance was considered if there were no fragments on USG screening after three weeks. The stone free rate in RIRS is 86.6% in the first sitting and 100% at second sitting.
Methods and results
Between July 2004 and January 2014 , one urologist (B.G.) evaluated medical data related to semirigid ureteral ureteroscopy (URS) with ureterolithotripsy using a Holmiun laser performed in our centre. The aim of this study was to demonstrate how, in a center such as ours with high patient numbers (a total of more 100 cases of upper ureteric , medium ureteric and low ureteric stones ) it is possible to perform a ureterolithotripsy for ureteral stones (ULT) using a minimum set of instruments to complete the treatment without complications and with a good clinic outcome. The instrumentation we used was extremely limited
With the development of smaller caliber ureteroscopes and the introduction of improved instrumentation, including the holmium:YAG laser, ureteroscopy has evolved into a safer, more effective method of treating ureteral stones. The use of holmium laser lithotripsy is a safe and effective means of treating ureteral stones regardless of sex, age, stone location, or stone size. Complications were uncommon. The instrumentation we used was extremely limited, in order to reduce costs related to the procedure to an absolute minimum whilst maintaining the two quality indicators for the procedure, namely success-rate and length of hospitalisation (86.1% and 34 hours), which reflect those obtained with other experiences.Argomenti: calcolosi