title: Assessment of the Effectiveness, Safety, and Reproducibility of Micro-Ureteroscopy in the Treatment of Distal Ureteral Stones in Women: A Multicenter Prospective Study.
abstract: The aim of this study is to assess the effectiveness, safety, and reproducibility of the micro-ureteroscopy (m-URS) in the treatment of distal ureteral stones in women.
  
  
  
  A multicenter, prospective observational study was designed and conducted between March and December 2015. We included women having at least one stone in the distal ureter and being a candidate for surgical treatment using the 4.85F sheath of MicroPerc®. Patients with clinical criteria and/or laboratory analysis indicating sepsis or coagulation alteration were excluded.
  
  
  
  Thirty-nine women were operated in eight hospitals. The profile of the patients was fairly homogeneous among hospitals. Only differences were found in age, preoperative stent, and the result of the previous urine culture. Immediate stone-free status was achieved in 88.2% and 100% 7 days after the procedure. 97.4% of patients did not present any complication in the postoperative period, with only one case with complication Clavien II. Postureteroscopic Lesion Scale (PULS) in 76.9% of patients did not show any injury, 20.5% had lesions grade 1, and grade 2 lesions 2.6%. As for the reproducibility of m-URS between hospitals, statistical analysis of the results showed differences between all the centers participating in the study.
  
  
  
  m-URS is an effective, safe, and reproducible technique that minimizes surgical aggression to the ureteral anatomy. Satisfactory and comparable results to "conventional" ureteroscopy were obtained in the treatment of distal ureteral stones in women, although clinical trials are needed. The reduction of the ureteral damage may reduce secondary procedures and increase the cost-effectiveness of the procedure.
authors: 1 University General Hospital of Alicante , Alicante, Spain .
authors: Juan-Pablo
authors: JP
authors: Caballero-Romeu
authors: 2 University Hospital of Vinalopo , Elche, Spain .
authors: Juan-Antonio
authors: JA
authors: Galán-Llopis
authors: 3 Santiago de Compostela University Hospital , A Coruña, Spain .
authors: Daniel
authors: D
authors: Pérez-Fentes
authors: 4 La Fe University and Politechnic Hospital , Valencia, Spain .
authors: Alberto
authors: A
authors: Budia-Alba
authors: 5 Rio Hortega University Hospital , Valladolid, Spain .
authors: Marcos
authors: M
authors: Cepeda-Delgado
authors: 6 La Ribera University Hospital , Alzira, Spain .
authors: Jose-Luis
authors: JL
authors: Palmero-Marti
authors: 7 Department of Urology, La Paz University Hospital , Madrid, Spain .
authors: Jose-Ramón
authors: JR
authors: Cansino-Alcaide
authors: 8 Department of Community Nursing, Preventive Medicine and Public Health and History of Science Health, Faculty of Health Sciences, University of Alicante , Alicante, Spain .
authors: Pablo
authors: P
authors: Caballero-Pérez
authors: 9 Department of Urology, IMQ Zorrotzaurre Clinic , Bilbao, Spain .
authors: Gaspar
authors: G
authors: Ibarluzea-Gonzalez
mesh_terms: D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D005260:Female; D006761:Hospitals; D006801:Humans; D008875:Middle Aged; D061214:Patient Safety; D011184:Postoperative Period; D011446:Prospective Studies; D015203:Reproducibility of Results; D015607:Stents; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000601:surgery*; D018666:Ureteroscopy / Q000191:economics / Q000295:instrumentation / Q000379:methods*
keywords: miniaturization; minimally invasive surgical procedures; reproducibility of results; ureteroscopy; urinary calculi