Presented by: Aleksander Petrov
St. Petersburg State University – Pirogov Clinic of Advanced Medical Technologies St. Petersburg, Russian Federation

Introduction

Flexible ureteropyeloscopy (URS) with laser lithotripsy is the gold standard for minimally invasive treatment in patients with kidney stones up to 20 mm. Currently, there is no objective data on the safety of bilateral interventions. The aim of our work was to analyze the results of bilateral flexible URS (D-URS) versus unilateral flexible URS (O-URS).

Materials

The research was made between July 2022 and December 2022 and involved 80 patients divided into 2 groups. Group 1 patients (n=40) underwent O-URS and Group 2 patients (n=40) were subjected to D-URS.  The baseline figures were comparable between the groups, but in the D-URS group there was a 39% higher incidence of multiple stones (p>0.002) and a 28% higher incidence of stones in the lower bowl groups (p>0.001). Previous interventions were also more frequent in group 1 (D-URS) patients.  A surgical indication was the presence of a stone up to 20mm in size.

Results

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The rates of complete stone clearance did not differ considerably between the groups and were amounted to 95% and 97.5% respectively (p>0.9).  No serious complications of Clavien III-V were observed in either group (p>0.9).

Conclusion

D-URS is a safe and effective technique to treat patients with bilateral kidney stones by removing stones from both sides in a single anaesthetic. These interventions reduce the overall duration and cost of treatment and allow rapid recovery. Further research is required to determine the role of bilateral flexible URS in the surgical treatment of patients with bilateral nephrolithiasis.

 

Funding

The study was not sponsored (own resources).

Lead Authors

Nariman Gadzhiev,, M.D., Dr.Sc. (Med);
St. Petersburg State University – Pirogov Clinic of Advanced Medical Technologies St. Petersburg, Russian Federation

Co-Authors

Ivan Gorgotsky, M.D., PhD,
Pirogov Clinic of Advanced Medical Technologies; St. Petersburg State University St. Petersburg, Russian Federation

Dmitrii Shkarupa, M.D., Dr.Sc. (Med)
Pirogov Clinic of Advanced Medical Technologies; St. Petersburg State University St. Petersburg, Russian Federation

Vigen Malkhasyan, M.D., Dr.Sc. (Med)
Department of Urology A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of the Russion Federation

Vladimir Vorobev, M.D., PhD,
Department of General Surgery and Anesthesiology, Irkutsk State Medical University, Irkutsk, Russian Federation

Andrei Shkarupa, M.D., Dr.Sc. (Med);
Pirogov Clinic of Advanced Medical Technologies; St. Petersburg State University St. Petersburg, Russian Federation