• linkedin
  • Increase Font
  • Sharebar

    Flexible URS found safe, effective in stones <2 cm

    Low morbidity, ‘excellent’ clinical outcomes’ observed, researchers report

    Hanover, NH—Flexible ureteroscopy is a safe and highly effective approach for treating proximal ureteral stones measuring <2 cm, according to the findings of a multi-institutional, prospective clinical trial.

    RELATED: Urologist self-referral increases likelihood of CT, ESWL

    Conducted at 10 large stone treatment centers and using very strict entry criteria, the study enrolled 69 patients over a period of 2 years. Eligible patients were adults with a solitary proximal ureteral calculus <2 cm and without concomitant ipsilateral renal calculi or prior ureteral stenting. They were treated using flexible ureteroscopy with Holmium laser lithotripsy and ureteral stent placement.

    Outcomes showed the procedure was associated with low morbidity and a high stone-free rate. Based on follow-up at 4 to 6 weeks post-treatment in 62 patients who returned for follow-up, the stone-free rate was 95%.

    Elias Hyams, MDDr. Hyams“Both a recent systematic review of the literature [J Urol 2012; 188:130-7] and the AUA guidelines on treatment of ureteral stones conclude there is inadequate evidence to make any recommendation on the use of ureteroscopy versus ESWL for the management of proximal ureteral calculi <2 cm. This prospectively designed single-arm trial was undertaken to establish the benchmark efficacy of flexible ureteroscopy for these particular stones,” explained first author Elias Hyams, MD, assistant professor of surgery at Geisel School of Medicine, Dartmouth College, Hanover, NH.

    Benchmark for future research

    “Our results show excellent clinical outcomes, and we believe our data can be used for comparing results with other techniques in future studies and to inform the debate on the optimal management of these stones,” Dr. Hyams said of the study, which was presented at the 2014 AUA annual meeting in Orlando, FL and subsequently published in the Journal of Urology (2015; 193:165-9).


    Continue to the next page for more.

    More on Stone Disease

    Ultrasound stone repositioning found safe, effective

    Fluids, meds highlight ACP stone prevention guide

    How do you manage large kidney and ureteral stones?

    Cheryl Guttman Krader
    Cheryl Guttman Krader is a contributor to Dermatology Times, Ophthalmology Times, and Urology Times.


    You must be signed in to leave a comment. Registering is fast and free!

    All comments must follow the ModernMedicine Network community rules and terms of use, and will be moderated. ModernMedicine reserves the right to use the comments we receive, in whole or in part,in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

    • No comments available