The following is a summary of “Non-Papillary Access for the Percutaneous Antegrade Treatment of Renal and Ureteral Stones,” published in the JANUARY 2023 issue of Urology by Tsaturyan, et al.
For a study, researchers sought to assess the viability and effectiveness of medial non-papillary percutaneous access for the antegrade treatment of various ureteral stone sites, both with and without concurrent renal stone disease.
They analyzed data prospectively gathered from 72 patients who were receiving percutaneous antegrade ureterolithotripsy. Included were stones that could be found anywhere in the ureter, whether or not they were also renal stones. Depending on the size of the stone pelvicalyceal system, a 12Fr, 22Fr, or 30Fr percutaneous tract dilatation was performed. In addition, perioperative and demographic data were collected and assessed. High-power holmium laser equipment like the Lithoclast Trilogy (EMS Medical, Nyon, Switzerland), Cyber Ho 150 (Quanta System, Samarate, Italy), or MOSES Pulse 120H (Lumenis Ltd, Yokneam, Israel) were used for lithotripsy.
The patients’ average age and total stone size were 57.9±27.1 years and 24.2±5.4 mm, respectively. 36.9±14.8 minutes on average were spent manipulating. Hemoglobin loss was 1.02±0.18 gr/dL on average during the 2.5±0.5 days on average that patients spent in the hospital. During percutaneous antegrade ureterolithotripsy, the stone-free rate was 95.8% (69 patients), and the overall complication rate was 5.6%, with 3 cases of fever and one case of extended hematuria managed conservatively in each case.
A safe and effective method for treating patients with ureteral stones, whether or not renal stones are present, is non-papillary percutaneous antegrade ureterolithotripsy. With a weighted risk of developing postoperative complications, a high stone-free rate of 95.8% was found one month following the procedure.