title: Semi-rigid ureteroscopy for ureteric and renal pelvic calculi: Predictive factors for complications and success.
abstract: OBJECTIVE
  To analyse and compare the effect of stone site and size, method of lithotripsy, and level of experience on the results and complications of semi-rigid ureteroscopy for ureteric and renal pelvic stones.
  
  
  METHODS
  Between April 2010 and May 2011, 90 patients underwent 95 ureteroscopies, using 7.5- and 9-F semi-rigid ureteroscopes, with or without pneumatic or laser lithotripsy. The peri-operative findings were analysed and compared.
  
  
  RESULTS
  The mean (SD) longest diameter of the stones was 11.8 (4.5) mm. Laser lithotripsy was used in 32 cases and pneumatic lithotripsy in 26. There were complications in 35 procedures in the form of colicky pain (2%), haematuria (1%), stone migration (7%), equipment failure (5%), access failure (8%), mucosal injury (7%), fever (2%) and extravasation (3%).The calculi were successfully retrieved in 75 patients (83%). The success rate was 95%, 77%, 85%, and 53% in the lower, middle, upper ureter and renal pelvis, respectively.
  
  
  CONCLUSIONS
  Upper ureteric stones can be managed safely with the semi-rigid ureteroscope. Renal pelvic stones are associated with a lower success rate, and thus they were not a primary indication for ureteroscopic intervention. The secondary ureteroscopic management of renal pelvic stones improved the results of subsequent alkalinisation or shock-wave lithotripsy if they could not be eradicated completely. The failure rate was significantly small in lower ureteric stones and stones of <10 mm. Less experience, a stone size of >15 mm and patients ⩽2 years old were associated with more complications or a lower success rate. There was no significant difference in the success or complication rate between laser and pneumatic lithotripsy.
authors.affiliation: Department of Urology, Kasr Al-Ainy Hospitals, Cairo University, Cairo, Egypt.
authors.forename: Khaled
authors.initials: K
authors.lastname: Mursi
authors.affiliation: Department of Urology, Kasr Al-Ainy Hospitals, Cairo University, Cairo, Egypt.
authors.forename: Mohammed S
authors.initials: MS
authors.lastname: Elsheemy
authors.affiliation: Department of Urology, Kasr Al-Ainy Hospitals, Cairo University, Cairo, Egypt.
authors.forename: Hany A
authors.initials: HA
authors.lastname: Morsi
authors.affiliation: Department of Urology, Kasr Al-Ainy Hospitals, Cairo University, Cairo, Egypt.
authors.forename: Abdel-Karim
authors.initials: AK
authors.lastname: Ali Ghaleb
authors.affiliation: Department of Urology, Kasr Al-Ainy Hospitals, Cairo University, Cairo, Egypt.
authors.forename: Omar M
authors.initials: OM
authors.lastname: Abdel-Razzak
keywords: (s)URS, (semi-rigid) ureteroscopy; C&S, culture and sensitivity; LL, laser lithotripsy; Laser; Lithotripsy; PCN, percutaneous nephrostomy; PL, pneumatic lithotripsy; Pneumatic; US, ultrasonography; Ureteroscopy; Urinary tract stones