[Flexible ureteroscopy in upper urinary tract diseases].
OBJECTIVE
Evaluation of active deflection flexible miniureterorenoscopes for diagnostic or therapeutic applications in the management of upper urinary tract diseases.


METHODS
The authors report a series of 111 consecutive patients undergoing a total of 137 flexible ureteroscopies for upper urinary tract disease between November 1997 and April 2001. The procedures were performed for diagnostic purposes (54 cases: 39%) or therapeutic purposes (83 cases; 61%). A successful procedure was defined as achievement of the objective defined when establishing the indication for ureteroscopy. The mean age of the patients was 51 +/- 15 years. The main diseases investigated or treated were stones (66%) and urothelial tumours (25%).


RESULTS
The mean operating time was 42 +/- 22 min. The median length of postoperative hospital stay was 2 days (range: 0-27 days). 8% of patients did not require any postoperative ureteric drainage. 78% of the flexible ureteroscopies performed were successful. Complications were observed in 8% of cases, mainly macroscopic haematuria, including 3 major complications in the form of ureteric perforation. Serious intraoperative equipment damage was observed in 4% of cases.


CONCLUSIONS
Ureteroscopy with a flexible mini-ureteroscope is an effective, reproducible and minimally traumatic diagnostic and therapeutic technique for lesions situated above the iliac vessels. The use of various instruments, including the Holmium:Yag laser, should increase the range of possibilities of endoscopic techniques. The major limitation of active deflection flexible mini-ureterorenoscopes remains their fragility.
Nahon
Olivier
O
Service de Chirurgie Urologique, Hôpital Salvator, 249, Bd. de Sainte-Marguerite, 13274 Marseille. ONAHON@mail.ap-hm.fr
Lay
Franck
F
Lechevallier
Eric
E
Coulange
Christian
C
D004867:Equipment Design; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis* / Q000628:therapy*; D008875:Middle Aged; D014515:Ureteral Diseases / Q000175:diagnosis* / Q000628:therapy*; D020709:Ureteroscopes; D018666:Ureteroscopy / Q000379:methods