title: Flexible Ureterorenoscopy for Renal and Proximal Ureteral Stone in Patients with Previous Ureteral Stenting: Impact on Stone-Free Rate and Morbidity.
abstract: To analyze results (stone-free rate [SFR]) and complications after flexible ureterorenoscopy (f-URS) for renal or lumbar ureteral lithiasis in patients with a previous ureteral stenting (US).
  
  
  
  We conducted a single-center retrospective study, including all f-URS procedures achieved in our department, between January 2004 and December 2010, for renal or lumbar ureteral urinary lithiasis. In total, 497 procedures were performed: 316 procedures in patients with a ureteral stent placed before the surgery for renal colic, sepsis, or renal failure (group 1) and 181 procedures in patients without US (group 2). Success was defined as a complete SFR at 6-month follow-up. Surgical morbidity was defined using the Clavien-Dindo grading system.
  
  
  
  Groups 1 and 2 were well balanced in terms of demographic data, number, and size of stones. Ureteral location was significantly higher in group 1 (30.2% vs 16.3%, p = 0.0006). Surgery characteristics were similar in both groups. By univariate analysis, SFR tended to be slightly higher in the group with prior ureteral stenting (72% vs 63%, p = 0.05). SFR for ureteral location was also higher after previous ureteral stenting (81.5% vs 59.4%, p = 0.023). By multivariate analysis, only stone size and number were correlated with f-URS failure. Complication rate was comparable in both groups (10.7% vs 11.8%, p = 0.7).
  
  
  
  Technical aspects of the f-URS procedure were not modified by ureteral stenting. We found that f-URS in patients with ureteral stenting was not associated with a better SFR, except in case of ureteral location in univariate analysis. Ureteral stenting was not independently related to f-URS outcome by multivariate analysis.
authors.affiliation: 1 Department of Urology and Renal Transplantation, University Hospital of Besançon , Besançon, France .|2 UFR Sciences Médicales et Pharmaceutiques, University of Franche Comté , Besançon, France .
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Dessyn
authors.affiliation: 1 Department of Urology and Renal Transplantation, University Hospital of Besançon , Besançon, France .
authors.forename: Loïc
authors.initials: L
authors.lastname: Balssa
authors.affiliation: 1 Department of Urology and Renal Transplantation, University Hospital of Besançon , Besançon, France .
authors.forename: Eric
authors.initials: E
authors.lastname: Chabannes
authors.affiliation: 1 Department of Urology and Renal Transplantation, University Hospital of Besançon , Besançon, France .|2 UFR Sciences Médicales et Pharmaceutiques, University of Franche Comté , Besançon, France .
authors.forename: Baptiste
authors.initials: B
authors.lastname: Jacquemet
authors.affiliation: 1 Department of Urology and Renal Transplantation, University Hospital of Besançon , Besançon, France .
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bernardini
authors.affiliation: 1 Department of Urology and Renal Transplantation, University Hospital of Besançon , Besançon, France .|2 UFR Sciences Médicales et Pharmaceutiques, University of Franche Comté , Besançon, France .
authors.forename: Hugues
authors.initials: H
authors.lastname: Bittard
authors.affiliation: 1 Department of Urology and Renal Transplantation, University Hospital of Besançon , Besançon, France .
authors.forename: Guillaume
authors.initials: G
authors.lastname: Guichard
authors.affiliation: 1 Department of Urology and Renal Transplantation, University Hospital of Besançon , Besançon, France .|2 UFR Sciences Médicales et Pharmaceutiques, University of Franche Comté , Besançon, France .|3 INSERM UMR 1098 , Besançon, France .
authors.forename: François
authors.initials: F
authors.lastname: Kleinclauss
mesh_terms: D000328:Adult; D000368:Aged; D003710:Demography; D005260:Female; D006801:Humans; D007668:Kidney / Q000601:surgery*; D007669:Kidney Calculi / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D015999:Multivariate Analysis; D056844:Renal Colic / Q000601:surgery; D051437:Renal Insufficiency / Q000601:surgery; D012189:Retrospective Studies; D018805:Sepsis / Q000601:surgery; D015607:Stents; D016896:Treatment Outcome; D014513:Ureter; D014514:Ureteral Calculi / Q000601:surgery*; D018666:Ureteroscopy / Q000379:methods*; D052878:Urolithiasis / Q000150:complications*
keywords: flexible ureterorenoscopy; stone free rate; surgical complications; ureteral stent