Combination of extracorporeal lithotripsy and flexible ureterorenoscopy optimize renal lithiasis therapy.
OBJECTIVE
Describe our initial experience in the treatment of renal lithiasis with extracorporeal lithotripsy controlled by simultaneous flexible ureterorenoscopy and combined with holmium laser lithotripsy.


METHODS
We performed this novel technique in a previously selected patient with left renal lithiasis, two in the superior calix, two in the medium calix and two in the inferior calix, the biggest of which was placed in medium calix and was 6mm long. We proceeded to an extracorporeal shock wave lithotripsy and a simultaneous flexible ureterorenoscopy for better controlling the fragmentation of the lithiasis with the use of a holmium laser. In the immediate post-operative, an ultrasound was performed and, one month later, a computerized tomography (CT) was done.


RESULTS
The complete fragmentation of all the lithiasis was obtained and a double-J catheter was placed. After the assessment of the absence of stone fragments by CT the catheter was removed. No intra-operative or post-operative complications were described.


CONCLUSIONS
The technique described is novel, safe and reproducible. The good result obtained through this combined technique increases our interest in continuing with its application and consider it as an option for the treatment of renal lithiasis in our patients.
Servicio de Urología, Hospital Universitario Puerta del Mar, Cádiz, España. Electronic address: albertoperezlanzac@gmail.com.
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Pérez-Lanzac
Servicio de Urología, Hospital Universitario Puerta del Mar, Cádiz, España.
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Parra-Serván
Servicio de Urología, Hospital Universitario Puerta del Mar, Cádiz, España.
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León-Delgado
Servicio de Urología, Hospital Universitario Puerta del Mar, Cádiz, España.
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Okhunov
Servicio de Urología, Hospital Universitario Puerta del Mar, Cádiz, España.
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Lusch
Servicio de Urología, Hospital Universitario Puerta del Mar, Cádiz, España.
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Álvarez-Ossorio
D003131:Combined Modality Therapy; D004867:Equipment Design; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008096:Lithotripsy; D008875:Middle Aged; D020709:Ureteroscopes; D018666:Ureteroscopy
Lithiasis; Lithotripsy; Litiasis; Litotricia; Ureterorenoscopy; Ureterorrenoscopia