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Factors affecting complication rates of retrograde flexible ureterorenoscopy: analysis of 1571 procedures—a single-center experience

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Abstract

Purpose

To evaluate the factors affecting complication rates of flexible ureteroscopy and laser lithotripsy (FURSL).

Materials and methods

Data on a total of 1395 patients, with 1411 renal units underwent 1571 procedures with FURSL for renal and/or proximal ureteral stones between April 2012 and January 2016, were retrospectively analyzed. Complications were assessed using the Satava and modified Clavien systems. Univariate and multivariate analyses were done to determine predictive factors affecting complication rates.

Results

The mean patient age in the total procedures was 45.68 ± 14.00 years (range 2–86 years), and the mean stone size was 15.15 ± 8.32 mm (range 5–75 mm). The overall success rate was 95.6 %. A total of 209 (13.3 %) cases suffered from complications with intraoperative complications rates of 5.9 % and postoperative complication rates of 7.3 %. Univariate analysis revealed no significant difference in complication rates in respect of age, gender, body mass index, use of ureteral access sheath, operation time, bleeding disorder, solitary kidney, preoperative stenting, American Society of Anesthesiologists score, repeated procedure or location of stones (all p value >0.05). Complication rates were determined to be significantly affected by stone size (p = 0.026), multiplicity (p = 0.028) and the presence of congenital renal abnormality (p < 0.01). The only significant factor in multivariate analysis was the presence of congenital renal abnormalities (p = 0.02).

Conclusions

The results of the current study indicated that stone size, stone number and the presence of congenital renal abnormalities were factors affecting complication rates after FURSL, although congenital renal abnormality was the only independent predictor among these risk factors.

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Abbreviations

FURSL:

Flexible ureterorenoscopy and laser lithotripsy

SWL:

Shock wave lithotripsy

PNL:

Percutaneous nephrolithotomy

URS:

Ureteroscopic stone removal

CIRFs:

Clinically insignificant urolithiasis

BMI:

Body mass index

ASA:

American Society of Anesthesiologists

UTI:

Urinary tract infection

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Author’s contribution

O Bas participated in protocol/project development, data analysis and manuscript writing. C Tuygun performed the protocol/project development and data collection or management. O Dede contributed to protocol/project development and data analysis. S Sarı, MÇ Çakıcı, U Öztürk and G Göktuğ were involved in data collection or management and data analysis. A İmamoğlu participated in protocol/project development and manuscript editing.

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Authors and Affiliations

  1. Department of Urology, Diskapi Yildirim Beyazid Training and Research Hospital, Irfan Bastug Street, Altindag, Ankara, 06110, Turkey

    Okan Baş, Can Tuygun, Mehmet Çağlar Çakıcı, Ufuk Öztürk, Göksel Göktuğ & Abdurrahim İmamoğlu

  2. Department of Urology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey

    Onur Dede

  3. Department of Urology, Sarıkamış State Hospital, Kars, Turkey

    Sercan Sarı

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  1. Okan Baş
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Correspondence to Okan Baş.

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The authors declare that they had no conflicts of interests.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Baş, O., Tuygun, C., Dede, O. et al. Factors affecting complication rates of retrograde flexible ureterorenoscopy: analysis of 1571 procedures—a single-center experience. World J Urol 35, 819–826 (2017). https://doi.org/10.1007/s00345-016-1930-3

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  • DOI: https://doi.org/10.1007/s00345-016-1930-3

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