Category: Clinical Stones: Ureteroscopy
Introduction & Objective :
Minimally invasive treatment of renal stones had significantly improved with advancement in holmium laser and miniaturization of the flexible ureteroscopes. With the continued innovation and refinement, the role of flexible ureteroscopy in the treatment of ureteric and renal calculi had shown worldwide variation. We conducted this survey to better understand the current trends of flexible ureteroscopy in clinical practice.
On July 2016, an online questionnaire was disseminated to the members of the Endourological society for assessment of surgeons prospective in utilizing Flexible ureteroscopy (fURS). Anonymous responses were collected through the Survey Monkey platform, after three waves of distribution. Responders were divided into three groups according to case volume per year (100 case/year). Statistical analyses were performed using JMP™.
Results : We received 146 responses from 41 countries with the highest rate of response from North America (37%) followed by Europe (25%). fURS was utilized for treating > 2cm renal stones in 51% of respondents. Table 1 summarizes the responses according to case volume. Surgeons performing >100 cases/year used fURS more in calyceal diverticulum stones (87%, p=0.001), ureteral malignancies (90%, p=0.0001), >2cm renal stones (73%, p=0.0001), offer fURS for resident’s curriculum (74%, p = 0.002) and to discharge patient on same day (68%, p=0.005). Endourologists commencing 100 /year (66% versus 50% in those with case load<50/ year)(p=0.01).
fURS is gaining more popularity for treating large stones ( > 2 cm), especially among surgeon performing >100 cases /year. Ureteral access sheath is more common among experts, while introduction over a guidewire is more common in less experienced endourologist.
Mohamed Elshazly– professor of urology, Menoufia University, Egypt, Shibin Elcom, Al Minufiyah, Egypt
Mohamed Omar– Shebin Elkom, Al Minufiyah, Egypt
Omar Alhunaidi– Kuwait, Al Farwaniyah, Kuwait
Abdulrahman Ahmed– kuwait, Al Farwaniyah, Kuwait
Ali Alamiri– Kuwait, Al Farwaniyah, Kuwait
Feras Alajrawi– Kuwait, Al Farwaniyah, Kuwait
Abdullatif Al-Terki– Consultant in Urology, Amiri Hospital, Kuwait, Hawalli, Kuwait
Ahmed R. EL-Nahas– Consultant in Urology, Amiri Hospital, Mansoura, Ad Daqahliyah, Egypt
professor of urology
Menoufia University, Egypt
Shibin Elcom, Al Minufiyah, Egypt