title: Flexible Ureteroscopic Management of Horseshoe Kidney Renal Calculi.
abstract: OBJECTIVE
  To evaluate the clinical efficacy of flexible ureteroscope (F-URS) combined with holmium laser lithotripter in treating renal calculi in horseshoe kidney.
  
  
  METHODS
  From November 2010 to December 2013, the medical history and charts of sixteen patients (mean age 42.9 ± 11.6 years, range 26-66 years), including 13 males and 3 females were analyzed retrospectively. Mean stone burden was 29 ± 8 mm (range 17-42 mm2). Mean stone digitized surface area (DSA) was 321 ± 94 mm2 (range 180-538 mm2). Under spinal anesthesia in a modified lithotomy position with the head down, rigid ureteroscope was placed firstly into the ureter to reach the level of the pelvis, a zebra guide wire was inserted and following the removal of the rigid ureteroscope, an ureteral access sheath was positioned along the guide wire, then passed the URF P-5 flexible ureteroscope into the renal cavities over the guidewire. After locating the stones, holmium laser lithotripsy was performed.
  
  
  RESULTS
  The average operative time was 92 ± 16 minutes (range 74-127 min.). No major complications were encountered. Ten patients obtained stone-free status with one session, four obtained stone-free status after two sessions. Single session stone-free rate was 62.5%, overall stone-free rate was 87.5%. Two patients have small residual stones in the lower pole.
  
  
  CONCLUSIONS
  F-URS combined with holmium laser lithotripter and nitinol basket, is safe and effective in dealing with moderate stone diameter (<30 mm) in HSKs with high clearance rates and low complication rates.
authors.affiliation: Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Ding
authors.affiliation: Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Yunteng
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Micro-Invasive Surgery Center, Shishi Overseas Chinese Hospital, Fujian, China.
authors.forename: Siping
authors.initials: S
authors.lastname: Gu
authors.affiliation: Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Yifan
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Peng
authors.affiliation: Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Bai
authors.affiliation: Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Min
authors.initials: M
authors.lastname: Ye
authors.affiliation: Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Qi
mesh_terms: D000328:Adult; D000368:Aged; D019468:Disease Management; D005260:Female; D000069337:Fused Kidney / Q000150:complications*; D006801:Humans; D007669:Kidney Calculi / Q000150:complications / Q000628:therapy*; D053844:Lasers, Solid-State / Q000627:therapeutic use; D017602:Lithotripsy, Laser / Q000145:classification / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D020709:Ureteroscopes; D018666:Ureteroscopy / Q000295:instrumentation*