title: [Flexible ureteroscopy and laser lithotripsy for kidney and ureter stone: indications, morbidity and outcome].
abstract: OBJECTIVE
  To report our experience with Flexible Ureteroscopy-laser (FU-L) in the treatment of renal and/or ureteric stones.
  
  
  METHODS
  We conducted a retrospective study of 191 kidney and/or ureteric stones treated in the urology department of New Civil Hospital (Strasbourg) over a period of 2 years. Two hundred and nineteen FU-L were performed. We were interested in the indications of FU-L, its complications, treatment outcomes and predictors of obtaining a stone-free outcome. Postoperative complications were reported according to the Clavien-Dindo classification.
  
  
  RESULTS
  The indications were first line in 62.3% of cases, failures of shock wave lithotripsy in 26.2% of cases and failure of alkalinization of urine in 5.2% of cases. As intraoperative complications, we had one case of ureteropelvic avulsion and one case of bronchospasm leading to stop ureteroscopy. Postoperative complications occurred after 38 FU-L (17.3%). All grades combined these postoperative complications were infectious in 50% of cases. They were grade I, II, III, IV and V respectively in 5.9; 7.3; 2.7; 1.3 et 0% of cases. Their occurrence was not significantly correlated to the size of the stones or the unilateral or bilateral nature of the FU-L. The overall rate of stone-free was 71.7%. The factors determining significantly a stone-free outcome were the size of kidney stone and experience of the operator.
  
  
  CONCLUSIONS
  In our center, the FU-L is increasingly used as first-line option due to its low morbidity and excellent results especially for the treatment of kidney stones less than 20mm and ureteric stones. It is a quality alternative to PCNL in kidney stones over 20mm.
authors.affiliation: Service d'urologie, nouvel hôpital civil, 1, porte de l'Hôpital, 67091 Strasbourg, France.
authors.forename: B
authors.initials: B
authors.lastname: Fall
authors.affiliation: Service d'urologie, nouvel hôpital civil, 1, porte de l'Hôpital, 67091 Strasbourg, France. Electronic address: pmouracade@hotmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Mouracade
authors.affiliation: Service d'urologie, nouvel hôpital civil, 1, porte de l'Hôpital, 67091 Strasbourg, France.
authors.forename: S
authors.initials: S
authors.lastname: Bergerat
authors.affiliation: Service d'urologie, nouvel hôpital civil, 1, porte de l'Hôpital, 67091 Strasbourg, France.
authors.forename: C
authors.initials: C
authors.lastname: Saussine
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D017602:Lithotripsy, Laser; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000628:therapy*; D018666:Ureteroscopy; D055815:Young Adult
keywords: Calculs; Flexible ureteroscopy-laser; Indications; Morbidity; Morbidité; Results; Résultats; Stones; Urétéroscopie souple-laser