title: The "Guidewire-Coil"-Technique to prevent retrograde stone migration of ureteric calculi during intracorporeal lithothripsy.
abstract: BACKGROUND
  Stone retropulsion represents a challenge for intracorporeal lithotripsy of ureteral calculi. The consequences are an increased duration and cost of surgery as well as decreased stone-free rates. The use of additional tools to prevent proximal stone migration entails further costs and risks for ureteral injuries. We present the simple technique of using a coil of the routinely used guidewire to prevent stone retropulsion.
  
  
  METHODS
  We retrospectively evaluated all patients with mid-to-proximal ureteral stones in 2014, which were treated by ureteroscopic lithotripsy (Ho: YAG and/or pneumatic lithotripsy). The preoperative stone burden was routinely assessed using low dose CT scan (if available) and/or intravenous pyelogram.
  
  
  RESULTS
  The study population consisted of 55 patients with 61 mid-to-proximal calculi. Twentyseven patients underwent semirigid ureterorenoscopy using the "Guidewire-Coil-Technique", the second group (n = 28) served as control group using the guidewire as usual. There has been a statistically significant reduction of accidental stone retropulsion (2/27 vs. 8/28, p < 0.05) as well as a decreased use of auxiliary procedures (p < 0.05) compared to the control group. No difference was observed in operative time. One ureteral injury in the control group required a prolonged ureteral stenting.
  
  
  CONCLUSIONS
  The "Guidewire-Coil-Technique" is a simple and safe procedure that may help to prevent proximal calculus migration and therefore may increase stone-free rates without causing additional costs.
authors.affiliation: Department of Urology, Helios Medical Center Wuppertal, Helios University Hospital Wuppertal, University of Witten/Herdecke, Heusnerstraße 40, Wuppertal, 42283, Germany. nici-markus.dreger@helios-kliniken.de.
authors.forename: Nici Markus
authors.initials: NM
authors.lastname: Dreger
authors.affiliation: Scott Department of Urology, Baylor College of Medicine Medical Center, 7200 Cambridge, Houston, TX, USA.|Department of Urology, Jena Medical Center, Friedrich-Schiller University, Bachstraße 18, Jena, 07743, Germany.
authors.forename: Friedrich Carl
authors.initials: FC
authors.lastname: von Rundstedt
authors.affiliation: Department of Urology, Helios Medical Center Wuppertal, Helios University Hospital Wuppertal, University of Witten/Herdecke, Heusnerstraße 40, Wuppertal, 42283, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Roth
authors.affiliation: Department of Urology, Helios Medical Center Wuppertal, Helios University Hospital Wuppertal, University of Witten/Herdecke, Heusnerstraße 40, Wuppertal, 42283, Germany.
authors.forename: Alexander Sascha
authors.initials: AS
authors.lastname: Brandt
authors.affiliation: Department of Urology, Helios Medical Center Wuppertal, Helios University Hospital Wuppertal, University of Witten/Herdecke, Heusnerstraße 40, Wuppertal, 42283, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Degener
mesh_terms: D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000295:instrumentation*; D007431:Intraoperative Complications / Q000517:prevention & control*; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014514:Ureteral Calculi / Q000601:surgery*
keywords: Intracorporeal lithotripsy; Stone migration; Stone retropulsion; Ureteric calculi; Ureterorenoscopy