title: Emergency ureteroscopic removal of ureteral calculi after first colic attack: is there any advantage?
abstract: OBJECTIVE
  To comparatively evaluate the efficacy of ureteroscopic stone treatment immediately after the first colic attack and in an electively planned manner.
  
  
  METHODS
  A total of 145 patients underwent semirigid ureteroscopic removal of obstructive ureteral calculi using 2 different approaches (group 1, 69 patients, and group 2, 76 patients). The 69 patients in group 1 were treated with appropriate medical therapy for a period of ≥7 days for colic pain and subsequently underwent either semirigid ureteroscopy or pneumatic lithotripsy in a planned manner. The 76 patients in group 2 underwent semirigid ureteroscopy after the first colic attack. The stone-free status, auxiliary procedures, and complications were evaluated between the 2 groups using the Mann-Whitney U test; for qualitative data, Fisher's exact test was used.
  
  
  RESULTS
  Of the 145 patients who underwent semirigid ureteroscopy, the mean stone size was 11.80±3.95 mm and 8.32±2.08 mm in the 2 groups. No patient experienced a major complication during or after the procedure. The stone-free rate was 87% and 90.7% in groups 1 and 2, respectively. The mean readmission rate to the emergency department for the management of a colic attack was 3.03±2.84 in group 1; no patient in group 2 required readmission.
  
  
  CONCLUSIONS
  Ureteroscopic stone removal immediately after the first colic attack in the cases of obstructive ureteral stones proved to be safe and effective. It has the main advantage of offering both immediate stone fragmentation and the relief of acute onset colic pain causing extreme discomfort.
authors: Department of Urology, Yeditepe University Medical School, and 2nd Urology Department, Sisli Etfal Training Research Hospital, Istanbul, Turkey.
authors: Kemal
authors: K
authors: Sarica
authors: Orhan
authors: O
authors: Tanriverdi
authors: Mustafa
authors: M
authors: Aydin
authors: Hakan
authors: H
authors: Koyuncu
authors: Cengiz
authors: C
authors: Miroglu