title: Feasibility and safety of bilateral same-session flexible ureteroscopy (FURS) for renal and ureteral stone disease.
abstract: BACKGROUND
  With rising incidence of urolithiasis, treatment of stones (both symptomatic and asymptomatic) in multiple locations including bilateral stones can be controversial and challenging. We report our experience and treatment outcomes in patients undergoing bilateral, same-session ureterorenoscopy (BS-URS) for bilateral ureteric and/or renal calculi, and discuss the advantages and disadvantages of such procedures.
  
  
  METHODS
  Between May 2012 and October 2013, 251 patients underwent ureteroscopic surgery for stone disease at our institution. Of these, 21 patients underwent 25 bilateral same-session ureterorenoscopy (BS-URS) procedures during this period. Stone-free status was defined as endoscopically stone-free or radiological fragments <2 mm.
  
  
  RESULTS
  The mean bilateral stone size was 21mm (range: 4-63 mm) with a mean operating time of 70 minutes (range 35-129 minutes). Fifteen procedures (60%) were done as day case procedures with a mean stay of 0.9 days (range 0-7 days). Of the 42 renal units treated, 80% (34/42) were stone-free after a single bilateral ureteroscopy session. A further 12% (5/42) were cleared after a re-look procedure making the overall stone free rate 92.8% (39/42). There were no major complications and 3 minor complications (2 early stent removals due to stent symptoms and 1 pyelonephritis requiring intravenous antibiotics).
  
  
  CONCLUSIONS
  Bilateral same-session ureteroscopy is a safe and effective treatment option for patients with bilateral ureteric and/or renal calculi, even with stones in multiple locations and increasing stone loads. However, as with all surgery, proper patient and equipment selection is crucial in terms of reducing complication rates and improving treatment outcomes.
authors.affiliation: University Hospital Southampton NHS Trust, Department of Urology, Southampton, United Kingdom.
authors.forename: Tamsin
authors.initials: T
authors.lastname: Drake
authors.affiliation: University Hospital Southampton NHS Trust, Department of Urology, Southampton, United Kingdom.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Ali
authors.affiliation: University Hospital Southampton NHS Trust, Department of Urology, Southampton, United Kingdom.
authors.forename: Bhaskar K
authors.initials: BK
authors.lastname: Somani
keywords: bilateral; flexible ureteroscopy; laser; renal stones; ureteral stones