title: Combined ureterorenoscopy for ureteral and renal calculi is not associated with adverse outcomes.
abstract: BACKGROUND
  We intended to evaluate the feasibility and effectiveness of the simultaneous rigid and flexible ureteroscopic treatment of symptomatic ureteral and ipsilateral small simultaneous calyceal stones. Outcomes of combined therapy were compared with monotherapy alone.
  
  
  METHODS
  In this retrospective study, group 1 consisted of 45 patients with middle or lower ureteral and ipsilateral small simultaneous calyceal stones treated by combined therapy. Group 2 included 45 patients with middle or lower ureteral stones only and treated by monotherapy. Stone characteristics, operative time, hospital stay, stone free rates, and complications were compared between groups 1 and 2. Stone free status was defined as no fragments and/or the presence of asymptomatic fragments smaller than 4 mm.
  
  
  RESULTS
  Mean BMI were 29.3 ±0.9 kg/m(2) and 27.6 ±0.6 kg/m(2) in groups 1 and 2, respectively. Mean ureteral stone size (7.6 ±0.4 mm vs. 8.0 ±0.4 mm, p = 0.261) and ureteral stone burden (56.0 ±5.5 mm(2) vs. 54.8 ±6.1 mm(2), p = 0.487) were similar between groups. Mean renal stone size and renal stone burden for group 1 were 7.1 ±0.8 mm and 83.7 ±11.3 mm(2). The mean operative time was significantly longer (for a mean of 32.5±1.2 minutes) for group 1 (p = 0.001). Ureteral stents were left in 38 (84.4%) and 19 (42.2%) patients in group 1 and group 2 (p = 0.001). Hospital stay and complication rates were similar between groups. SFRs were 100% for ureteral stones in both groups and 88.9% for renal stones within group 1.
  
  
  CONCLUSIONS
  Simultaneous ureteroscopic treatment of the ureteral and ipsilateral small calyceal stones prolongs operative time and increases use of ureteral stent without leaving any residual renal stones.
authors.affiliation: Memorial Şişli Hospital, Department of Urology, Istambul, Turkey.
authors.forename: Erdal
authors.initials: E
authors.lastname: Alkan
authors.affiliation: Memorial Şişli Hospital, Department of Urology, Istambul, Turkey.
authors.forename: Mirac
authors.initials: M
authors.lastname: Turan
authors.affiliation: Memorial Şişli Hospital, Department of Anesthesiology, Istambul, Turkey.
authors.forename: Oguz
authors.initials: O
authors.lastname: Ozkanli
authors.affiliation: Memorial Atasehir Hospital, Department of Urology, Istambul, Turkey.
authors.forename: Egemen
authors.initials: E
authors.lastname: Avci
authors.affiliation: Memorial Şişli Hospital, Department of Urology, Istambul, Turkey.
authors.forename: Mehmet Murad
authors.initials: MM
authors.lastname: Basar
authors.affiliation: Memorial Şişli Hospital, Department of Urology, Istambul, Turkey.
authors.forename: Oguz
authors.initials: O
authors.lastname: Acar
authors.affiliation: Memorial Şişli Hospital, Department of Urology, Istambul, Turkey.
authors.forename: Mevlana Derya
authors.initials: MD
authors.lastname: Balbay
keywords: renal stones; ureteral stones; ureteroscopy; urolithiasis