Management of Upper Urinary Tract Stones by Ureteroscopy in the Urology Department of the Nord Franche Comte Hospital

Abstract

Introduction: European association of urology (EAU), American Urology Association (AUA) and French Association of Urology (AFU) recommend either Extracorporeal Lithotripsy or Ureteroscopy for the surgical management of stones smaller than 2 cm in size. The aim of this study was to analyse the management of upper urinary tract stones by ureteroscopy in the urology department of the Nord Franche Comte Hospital. Methods: This was a prospective, descriptive, single-centre study lasting seven (07) months from 02 November 2021 to 31 May 2022 and involving 71 patients treated for lithiasis of the upper urinary tract by ureteroscopy. The preoperative, preoperative and postoperative characteristics of the patients and the disease, including the radiological control results, were studied. Results: One hundred and four stones were treated, the mean age was 55.94 ± 17.22 years, the sex ratio M/F 1.84; the circumstances of discovery were renal colic in 73.2%. The mean size of the stones was 9.12 mm; mean density 951.45 HU; the left side was most affected in 54.93% of cases. The stone was unique in 69.01% of cases. The preoperative Cytobacterioligical urine exam (CBUE) was positive in 15.5% of patients. Préstinting was performed in 84.5% of patients. We performed 45.1% rigid Ureteroscopy and 39.4% flexible Ureteroscopy. The average duration of the procedure was 46.63 min. Monobloc stone extraction was 35.2%, laser fragmentation 31%. Drainage was not performed in 50.7% of patients. The outpatient and postoperative complication rates were 87.3% and 9.86%, respectively. The stone-free rate was 90.1%. Conclusion: This initial evaluation of Ureteroscopy at Nord Franche Comte Hospital ( HNFC ), although based on a small sample, is satisfactory and in line with the literature.