title: Role of emergency ureteroscopy in the management of ureteric stones: analysis of 394 cases.
abstract: OBJECTIVE
  To analyse the outcomes of emergency ureteroscopy (URS) cases performed in Auckland City Hospital.
  
  
  METHODS
  We conducted a retrospective review of all emergency URS procedures performed at Auckland City Hospital between 1 January 2010 and 31 December 2011. Data on patients, stones and procedures were collected and analysed. Emergency URS failure was defined as fragments >3 mm or the need for a repeat procedure.
  
  
  RESULTS
  A total of 499 URS procedures were identified. Of these 394 (79%) were emergency procedures. The mean (sd; range) patient age was 48 (16; 13-88) years. In all, 83% of emergency URS cases had an American Society of Anesthesiologists (ASA) score of 1 or 2, 25% of stones were >9 mm, with a mean (sd) size of 8 (4) mm, and 285 procedures (72%) were successful. These patients were younger (47 vs 51 years), were more likely to have an ASA score of 1 (103 patients in the successful treatment group vs 26 in the failed treatment group), had smaller stones (7 vs 9 mm) and were more likely to have distal stones (P < 0.05). A total of 20 complications (5%) were recorded including six false passages and three mucosal injuries, one of which required radiological intervention, and 50 patients (13%) re-presented, for pain (76%), bleeding (10%) or infection (14%).
  
  
  CONCLUSIONS
  We showed that emergency URS is a feasible approach for the routine management of acute ureteric colic with a low complications rate. A subgroup of younger, healthier patients may benefit the most from the procedure.
authors.affiliation: Department of Urology, Auckland City Hospital, Auckland, New Zealand.
authors.forename: Kamran
authors.identifier: http://orcid.org/0000-0001-8241-4386
authors.initials: K
authors.lastname: Zargar-Shoshtari
authors.affiliation: Department of Urology, Auckland City Hospital, Auckland, New Zealand.
authors.forename: William
authors.initials: W
authors.lastname: Anderson
authors.affiliation: Department of Urology, Auckland City Hospital, Auckland, New Zealand.
authors.forename: Michael
authors.initials: M
authors.lastname: Rice
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004632:Emergency Medical Services / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D014514:Ureteral Calculi / Q000601:surgery*; D018666:Ureteroscopy / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult
keywords: complication; emergency; ureteric colic; ureteroscopy