title: Safety and Efficacy of Flexible Ureteroscopy in Combination with Holmium Laser Lithotripsy for the Treatment of Bilateral Upper Urinary Tract Calculi.
abstract: OBJECTIVE
  To retrospectively evaluate the safety and efficacy of flexible ureteroscopy (FURS) in combination with holmium laser lithotripsy for the treatment of bilateral upper urinary calculi.
  
  
  METHODS
  The stone-free status was defined as the absence of any stones or asymptomatic status, or the presence of clinically insignificant residual fragments <4 mm, and was assessed by plain kidney, ureter, and bladder X-ray. The operative time, stone-free rates (SFRs), serum creatinine (SCr), and complications were recorded.
  
  
  RESULTS
  During the operation, there was no bleeding, ureteral perforation, avulsion, and rupture. Postoperative hematuria was observed in 2 patients. SCr increased significantly on the first day after the procedure compared with the preoperative SCr, but after 4 weeks, the renal function significantly improved (p < 0.05). The SFR was 71.6% (63/88) on the first day after the first surgical procedure; it then increased to 86.4% (76/88) in the fourth week, and rose to 97.4% (76/78) after the second operation.
  
  
  CONCLUSIONS
  The results demonstrated that FURS in combination with holmium laser lithotripsy represented a favorable less-invasive alternative with high SFR and acceptable complication rates in the treatment of bilateral upper urinary tract calculi.
authors.affiliation: Department of Urology, Peking University Shougang Hospital, Beijing, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Yang
authors.forename: Hao
authors.initials: H
authors.lastname: Ning
authors.forename: Zheng
authors.initials: Z
authors.lastname: Liu
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhang
authors.forename: Chengfan
authors.initials: C
authors.lastname: Yu
authors.forename: Xianghua
authors.initials: X
authors.lastname: Zhang
authors.forename: Dongliang
authors.initials: D
authors.lastname: Pan
authors.forename: Kejia
authors.initials: K
authors.lastname: Ding
mesh_terms: D000328:Adult; D005260:Female; D006417:Hematuria / Q000097:blood; D006470:Hemorrhage; D006801:Humans; D053844:Lasers, Solid-State; D008096:Lithotripsy; D017602:Lithotripsy, Laser; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D061214:Patient Safety; D012189:Retrospective Studies; D016896:Treatment Outcome; D020709:Ureteroscopes; D018666:Ureteroscopy; D014545:Urinary Calculi / Q000628:therapy*; D014965:X-Rays
keywords: Bilateral upper urinary tract calculi; Flexible ureteroscopy lithotripsy; Holmium laser