Efficacy and functional outcome of flexible ureteroscopy for renal stones in patients with a solitary kidney

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Abstract

Aim:

The aim of the present study was to evaluate the efficacy and functional outcome of flexible ureteroscopy (fURS) for renal stones in patients with a solitary kidney.

Patients and Methods:

From February 2011 to February 2015, 60 patients with a solitary kidney underwent fURS for the treatment of renal stones. Factors, such as operation duration, complications and stone-free rate (SFR), were analysed. Changes in the renal function were evaluated by comparing preoperative and postoperative glomerular filtration rates (GFR) and serum creatinine. The stage of chronic kidney disease (CKD) was measured to evaluate the influence of fURS on renal function.

Results:

The total SFR were 76.67 per cent and 93.33 per cent after the first and final procedures, respectively. Postoperative minor complications, classified as Clavien grade II, were recorded in 4.2 per cent (2/48) and 25 per cent (3/12) of patients with renal stones < 2 cm and > 2 cm, respectively. Serious complications, classified as Clavien grade III, occurred in 8.3 per cent (1/12) with renal stones > 2 cm. For patients with renal stones < 2 cm, the preoperative and postoperative mean GFR, as well as serum creatinine, had statistical difference (P < 0.05). For patients with a solitary kidney with stage 5 CKD, fURS did not improve the renal function regardless of the stone size.

Conclusion:

fURS is a more effective and safer procedure, with a higher SFR and a lower rate of complications in treating stones < 2 cm in a solitary kidney than those > 2 cm. For patients with a solitary kidney with stage 5 CKD, fURS did not improve the renal function regardless of the stone size.

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