title: Clinical utility of dual active deflection flexible ureteroscope during upper tract ureteropyeloscopy.
abstract: OBJECTIVE
  To evaluate the clinical utility of a dual active deflection ACMI DUR-8 Elite ureteroscope in a referral endourology practice.
  
  
  METHODS
  Retrospective chart review was performed on 54 consecutive patients who underwent flexible ureteroscopy by a single surgeon (S.Y.N.) from February to July 2003. Cases in which standard flexible ureteroscopes alone could complete the procedure, cases in which standard flexible ureteroscopy could not complete the procedure and the DUR-8 Elite ureteroscope did, and cases in which both ureteroscopes failed to complete the procedure were analyzed.
  
  
  RESULTS
  A total of 54 procedures were performed on 37 patients. Three cases were not analyzed because they were distal ureter procedures. Of the remaining 51 procedures, 6 were removed from analysis because they were second-look procedures. When classified by diagnosis, 27 patients had stones (79.4%), 5 had cancer (14.7%), and 1 had hematuria (2.9%). The global success rate was 91.1%. The average use rate of the DUR-8 was 28.9%, and the success rate using the DUR-8 Elite was 69.2% in those cases in which it was necessary. Of the 13 cases in which the DUR-8 was used, 61.5% were for lower pole pathologic findings. The DUR Elite use and success rate in the lower pole was 57.1% and 75%, respectively. A statistically significant association was found between the diagnosis and procedure location (P = 0.00128).
  
  
  CONCLUSIONS
  Our preliminary data indicate that the dual deflecting DUR-8 Elite ureteroscope may be helpful in cases in which the single deflection flexible instruments fail to access and treat upper urinary tract pathologic findings.
authors.affiliation: Division of Urology, Department of Surgery, University of Wisconsin-Madison Medical School, Madison, Wisconsin 53792, USA.
authors.forename: Murali K
authors.initials: MK
authors.lastname: Ankem
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Lowry
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Slovick
authors.forename: Alejandro
authors.initials: A
authors.lastname: Munoz del Rio
authors.forename: Stephen Y
authors.initials: SY
authors.lastname: Nakada
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000175:diagnosis / Q000601:surgery; D006417:Hematuria / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007669:Kidney Calculi / Q000175:diagnosis / Q000601:surgery*; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000601:surgery; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D020709:Ureteroscopes; D018666:Ureteroscopy / Q000379:methods*; D014552:Urinary Tract Infections / Q000453:epidemiology