Factors affecting complication rates of retrograde flexible ureterorenoscopy: analysis of 1571 procedures-a single-center experience.
OBJECTIVE
To evaluate the factors affecting complication rates of flexible ureteroscopy and laser lithotripsy (FURSL).


METHODS
Data on a total of 1395 patients, with 1411 renal units underwent 1571 procedures with FURSL for renal and/or proximal ureteral stones between April 2012 and January 2016, were retrospectively analyzed. Complications were assessed using the Satava and modified Clavien systems. Univariate and multivariate analyses were done to determine predictive factors affecting complication rates.


RESULTS
The mean patient age in the total procedures was 45.68 ± 14.00 years (range 2-86 years), and the mean stone size was 15.15 ± 8.32 mm (range 5-75 mm). The overall success rate was 95.6 %. A total of 209 (13.3 %) cases suffered from complications with intraoperative complications rates of 5.9 % and postoperative complication rates of 7.3 %. Univariate analysis revealed no significant difference in complication rates in respect of age, gender, body mass index, use of ureteral access sheath, operation time, bleeding disorder, solitary kidney, preoperative stenting, American Society of Anesthesiologists score, repeated procedure or location of stones (all p value >0.05). Complication rates were determined to be significantly affected by stone size (p = 0.026), multiplicity (p = 0.028) and the presence of congenital renal abnormality (p < 0.01). The only significant factor in multivariate analysis was the presence of congenital renal abnormalities (p = 0.02).


CONCLUSIONS
The results of the current study indicated that stone size, stone number and the presence of congenital renal abnormalities were factors affecting complication rates after FURSL, although congenital renal abnormality was the only independent predictor among these risk factors.
Department of Urology, Diskapi Yildirim Beyazid Training and Research Hospital, Irfan Bastug Street, Altindag, Ankara, 06110, Turkey. drokanbas@hotmail.com.
Okan
O
Baş
Department of Urology, Diskapi Yildirim Beyazid Training and Research Hospital, Irfan Bastug Street, Altindag, Ankara, 06110, Turkey.
Can
C
Tuygun
Department of Urology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey.
Onur
O
Dede
Department of Urology, Sarıkamış State Hospital, Kars, Turkey.
Sercan
S
Sarı
Department of Urology, Diskapi Yildirim Beyazid Training and Research Hospital, Irfan Bastug Street, Altindag, Ankara, 06110, Turkey.
Mehmet Çağlar
MÇ
Çakıcı
Department of Urology, Diskapi Yildirim Beyazid Training and Research Hospital, Irfan Bastug Street, Altindag, Ankara, 06110, Turkey.
Ufuk
U
Öztürk
Department of Urology, Diskapi Yildirim Beyazid Training and Research Hospital, Irfan Bastug Street, Altindag, Ankara, 06110, Turkey.
Göksel
G
Göktuğ
Department of Urology, Diskapi Yildirim Beyazid Training and Research Hospital, Irfan Bastug Street, Altindag, Ankara, 06110, Turkey.
Abdurrahim
A
İmamoğlu
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology*; D007668:Kidney / Q000002:abnormalities / Q000601:surgery*; D007669:Kidney Calculi / Q000628:therapy*; D017602:Lithotripsy, Laser / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014514:Ureteral Calculi / Q000628:therapy*; D018666:Ureteroscopy / Q000379:methods*; D014564:Urogenital Abnormalities / Q000453:epidemiology*; D055815:Young Adult
Complication; Flexible ureterorenoscopy; Retrograde intrarenal surgery; Ureteroscopy; Urinary calculi