The effect of ureteroscope size in the treatment of ureteral stone: 15-year experience of an endoscopist.
OBJECTIVE
We aimed to investigate the ureter stone treatment results performed by using different- caliber semirigid ureteroscopes (URS).


METHODS
Adult patients who were treated for ureteral stones by a single endoscopist between January 2000 and March 2015 were analyzed. The patients were divided into 3 groups in accordance with the caliber of the ureteroscope used: 10/10.5 F Storz (Karl Storz, Tuttlingen, Germany) (January 2002-January 2005) URS was used in group 1, 8.9/9.8 F Storz (February 2005-December 2011) URS was used in group 2, and 6/7.5 FWolf (Richard Wolf, Knittlingen, Germany) (January 2012-March 2015) URS was used in group 3. Patients' age and gender, size and site of stones, stone-free rates (SFR), intra- and perioperative complication rates, and durations of surgery were compared among the groups. Intraoperative complications were classified according to modified Satava, and perioperative complications were classified according to modified Clavien classification systems.


RESULTS
A total of 2461 patients treated for ureteral stones were analyzed. There were 583 patients in group 1 (10/10.5 F Storz), 1302 patients in group 2 (8.9/9.8 F Storz), and 576 patients in group 3 (6/7.5 F Wolf). SFR were 83.7%, 87.4%, and 92.2% in groups 1, 2, and 3, respectively (p=0.01). Duration of surgery was 30.34±10.36 min in group 1, 31.61±10.10 min in group 2, and 42.40±7.35 min in group 3 (p=0.01). The overall complication rates classified according to modified Satava classification were 10.8%, 7.6%, and 6.9% (p=0.01) while grade 3 modified Satava complication rates were 1.9%, 1.5%and 0.5% in groups 1, 2, and 3, respectively (p=0.01).


CONCLUSIONS
In this study, we found that more frequent use of a small- caliber URS resulted in a longer duration of surgery and an increased rate for JJ stent insertion, however it facilitated a safer and more successful ureteroscopy procedure.
Clinic of Urology, Ankara Training and Research Hospital, Ankara, Turkey.
Muhammet Fatih
MF
Kılınç
Clinic of Urology, Ankara Training and Research Hospital, Ankara, Turkey.
Ömer Gökhan
ÖG
Doluoğlu
Clinic of Urology, Ankara Training and Research Hospital, Ankara, Turkey.
Tolga
T
Karakan
Clinic of Urology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey.
Ayhan
A
Dalkılıç
Clinic of Urology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey.
Nurettin Cem
NC
Sönmez
Clinic of Urology, Ankara Training and Research Hospital, Ankara, Turkey.
Cem Nedim
CN
Yücetürk
Department of Urology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey.
Berkan
B
Reşorlu
Complication; ureteral stones; ureteroscopy