Patient position and semi-rigid ureteroscopy outcomes.
BACKGROUND
Two positions have been reported for ureteroscopy (URS): dorsal lithotomy (DL) position and dorsal lithotomy position with same side leg slightly extended (DLEL). The aim of the present study was to compare the outcomes associated with URS performed with patients in DL vs. DLEL position.


METHODS
A total of 98 patients treated for ureteral calculi were randomized to either DL or DLEL position during URS, and were prospectively followed. Patients, stone characteristics and operative outcomes were evaluated.


RESULTS
Of the 98 patients included in the study, 56.1% were men and 43.9% women with a mean age of 42.6 +/- 16.8 years. Forty-eight patients underwent URS in DL position and 50 in DLEL position. Patients' age, mean stone size and location were similar between both groups. Operative time was longer for the DL vs. DLEL group (81.0 vs. 62.0 minutes, p = 0.045), mainly for men (95.2 vs. 63.9 minutes, p = 0.023). Mean fluoroscopy use, complications and success rates were similar between both groups.


CONCLUSIONS
Most factors associated with operative outcomes during URS are inherent to patient's condition or devices available at each center, and therefore cannot be changed. However, leg position is a simple factor that can easily be changed, and directly affects operative time during URS. Even though success and complication rates are not related to position, placing the patient in dorsal lithotomy position with an extended leg seems to make the surgery easier and faster.
Division of Urology, ABC Medical School, Santo Andre, Sao Paulo, Brazil.
Fernando
F
Korkes
Antonio C
AC
Lopes-Neto
Mario H E
MH
Mattos
Antonio C L
AC
Pompeo
Eric R
ER
Wroclawski
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000601:surgery*; D018666:Ureteroscopy / Q000379:methods*; D055815:Young Adult