Clinical efficacy of negative pressure combined with ureteroscopy and flexible ureteroscopic lithotripsy in treatment of unilateral upper urinary calculi

Abstract

Objective To evaluate the efficacy and safety of negative pressure combined with ureteroscopy (NPUR) with holmium laser in the treatment of unilateral upper urinary tract calculi in comparison with flexible ureteroscopy (FURS). Methods The clinical data were retrospectively analyzed for 211 patients of unilateral renal and proximal urinary calculi who received NPUR or FURS in the First Affiliated Hospital of Chongqing Medical University and the Thirteenth People's Hospital of Chongqing between December 2017 and December 2018. Of these patients, 106 received NPUR and the other 105 underwent FURS. Operation time, successful rate of ureteral access sheath placement, postoperative length of hospital stay, postoperative infection rate, stone free rate (SFR) at 1 d and 1 month after operation were compared between the 2 groups. According to the size of calculi, the 2 groups were divided 2 subgroups (> 2 cm and ≤2 cm) in order to make further analysis. Results There were significant differences in successful rate of ureteral access sheath placement, operation time and SFR at 1 d after operation (P 0.05). When the size of calculi was > 2 cm, the SFR was better in the NPUR group than the FURS group. But no difference was seen in the operation time. Conclusion NPUR and FURS are safe and effective in treatment for unilateral upper urinary tract calculi. NPUR is superior in treating larger (> 2 cm) stones, but the successful rate of same-session is lower than FURS.

Keywords

• negative pressure combined with ureteroacopy
• flexible ureteroscopy
• lithotripsy
• intra-renal calculi
• ureteral calculi