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Arab Journal of Urology
An International Journal
Volume 20, 2022 - Issue 4
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Stones/Endourology

Ultrasound versus fluoroscopy-guided ureteroscopy for distal ureteric stones in adults

ORCID Icon, , ORCID Icon, & ORCID Icon
Pages 197-203 | Received 29 Mar 2022, Accepted 04 Jun 2022, Published online: 20 Jun 2022
 

ABSTRACT

Objective

To evaluate the safety and efficacy of ultrasound (US) as alternative to fluoroscopy for guidance of ureteroscopy (URS) during treatment of distal ureteric stones in adults.

Materials and methods

This study enrolled 80 patients older than 18 years presented with a single distal ureteric radio-opaque stone of ≤15 mm in longest diameter. Patients were randomized and allocated into two groups: the fluoroscopy group and the ultrasound group (n = 40 patients in each group). Patients with bilateral ureteric stones, solitary kidney, ureteric congenital anomalies, history of failed ureteroscopy, history of ureteric surgery, patients with uremia and pregnant women were excluded. Patients’ demographics, stone characteristics, operative data, stone-free status, hospital stay and complications were evaluated in both groups.

Results

No statistically significant difference between both groups was found regarding patients’ demographics and stone characteristics. Also there was no statistically significant difference in comparing fluoroscopy group versus ultrasound group regarding operative time (29.48 ± 15.3 versus 31.28 ± 18.24 min; P = 0.83), stone-free rate (97.5% versus 95%; P = 1.0), overall complications (15% versus 12.5%; P = 0.75), or hospital stay (1.17 ± 0.6 versus 1.02 ± 0.16 days; P = 0.12). Four patients (10%) in the ultrasound group required the addition of fluoroscopy beside ultrasound.

Conclusion

Ultrasound is effective in guidance during ureteroscopy for distal ureteric stones. It was comparable to fluoroscopy in terms of stone free rate, operative time, overall complications, and hospital stay. However, fluoroscopy must be available to be used when needed.

Abbreviations

US: Ultrasound

URS: Ureteroscopy

KUB: kidney-ureter-bladder X-ray.

NCCT: non contrast computed tomography

JJ: double J stent

ESWL: extracorporeal shock wave lithotripsy

MCCS: modified Clavien classification system

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The derived data supporting the findings of this study are available from the corresponding author, Mohammad Abbas Faragallah on request.

Additional information

Funding

The authors have no funding to report.