📃 Paper Title: Differences in Ureteroscopic Stone Treatment and Outcomes for Distal, Mid-, Proximal or Multiple Ureteral Locations: The Clinical Research Office of the Endourological Society Ureteroscopy Global Study
🧍 Author: Enrique Perez Castro
🕒 Year: 2014
📚 Journal: European Urology
🌎 Country: Spain
ㅤContext to the study:
Can you tell me about an international multicentre study that investigated the effect of ureteric stone location on the efficacy and complication rate of ureteroscopic stone treatment?
ㅤ✅ Take-home message of study:
Ureteric stone location influences stone-free rates after ureteroscopy - lower stone-free rates are seen with stones in proximal or multiple locations
Ureteric stone location influences overall complication rates with ureteroscopy - higher complication rates are seen with stones in proximal or multiple locations
ㅤ Prospective, international, multi-center observational study
"Ureteroscopy Global Study" coordinated by the Endourological Society
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Study participants:
Total included in analysis for which data available: 9,555
Inclusion criteria:
Ureteral stones treated with ureteroscopy as primary treatment or where previous alternative treatment had failed
Aged ≥ 18 years
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Key study outcomes:
Stone-free status by location within ureter:
Distal: 94.2%
Mid: 89.4%
Proximal: 84.5%
Multiple locations: 76.6%
Overall complication rate by location within the ureter:
Distal: 2.4%
Mid: 2.5%
Proximal: 3.0%
Multiple: 4.6%
For proximal ureteric stones, the risk of failure or retreatment was higher for those patients that underwent semi-rigid ureteroscopy compared to flexible ureteroscopy:
Failure: 3.2% (semi-rigid) vs 1.0% (flexible)
Retreatment: 13.6% (semi-rigid) vs 7.7% (flexible)
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Study Limitations:
Inclusion of multiple international institutions meant that there was not a standardised treatment approach for all patients
No long-term follow-up data
Stone density, Hounsfield unit & Stone analysis were not recorded
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