title: Flexible Ureteroscopy versus Retroperitoneal Laparoscopic Ureterolithotomy for the Treatment of Proximal Ureteral Stones >15 mm: A Single Surgeon Experience.
abstract: OBJECTIVE
  To compare safety and effectiveness of flexible ureteroscopy (F-URS) and laparoscopic retroperitoneal ureterolithotomy (L-RU) in treatment of proximal ureteral stones larger than 15 mm.
  
  
  METHODS
  This study included 103 patients treated with L-RU (Group I), and 80 patients treated with F-URS (Group II) due to proximal ureteral stones larger than 1.5 cm, in a single center. Patients' characteristics and procedure-related parameters including success rate, operation time, hospital stay, postoperative visual analogue scale (VAS) scores, auxiliary procedures, and complications were compared between Groups I and II.
  
  
  RESULTS
  It was seen that both methods were effective in the treatment of large ureteral stones; however, R-LU provided a higher stone-free rate (100 vs. 87.5%), a lower complication rate (10.6 vs. 23.7%), and a shorter operation time (65.4 vs. 75.1 min). On the other hand, patients treated with F-URS had less postoperative pain, a shorter hospital stay, a faster return to daily activities.
  
  
  CONCLUSIONS
  For treatment of large proximal ureteral stones, L-RU provides significantly higher success and lower retreatment rate compared with F-URS. Our results also indicate that R-LU, which has been regarded as an invasive procedure is not as invasive as it is thought to be, and it must be kept in mind that F-URS may cause complications despite its noninvasive nature.
authors.affiliation: Department of Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
authors.forename: Volkan
authors.initials: V
authors.lastname: Tugcu
authors.forename: Berkan
authors.initials: B
authors.lastname: Resorlu
authors.forename: Selcuk
authors.initials: S
authors.lastname: Sahin
authors.forename: Arda
authors.initials: A
authors.lastname: Atar
authors.forename: Ramazan
authors.initials: R
authors.lastname: Kocakaya
authors.forename: Mithat
authors.initials: M
authors.lastname: Eksi
authors.forename: Ali Ihsan
authors.initials: AI
authors.lastname: Tasci
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008096:Lithotripsy / Q000379:methods; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010147:Pain Measurement; D011183:Postoperative Complications; D011446:Prospective Studies; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000628:therapy*; D020709:Ureteroscopes; D018666:Ureteroscopy / Q000379:methods*