CURRENT PRINCIPLES AND THERAPEUTIC CONCEPTS OF RETROGRADE INTRA-RENAL SURGERY FOR UROLITHIASIS


Authors: S. Agrawal ;  M. Král ;  A. Patel *
Authors‘ workplace: Department of Urology, St. Mary’s Hospital at Imperial College Healthcare NHS Trust and Imperial School of Medicine, London *
Published in: Urol List 2012; 10(1): 36-41

Overview

Retrograde Intra-Renal Surgery (RIRS) has undergone numerous technological advances since Hugh Hampton Young’s first foray in 1912 into the megaureter of a two month-old child using a 12Fr cystoscope, and the later introduction of rod lens optics by Harold Hopkins in 1960 [1,2]. A diverse array of equipment and accessories is available in modern practice and surgeons are increasingly tackling stone disease that previously would have required open or percutaneous surgery (PCNL), using a RIRS approach. This paper is based on the ureteroscopy part of the ESU Stone course, and aims to provided an update on recent advances and define a new and evolving framework for managing more complex stones.

Key words:
retrograde intra-renal surgery, urolithiasis, principles, therapeutic concepts


Sources

1. Young HH, McKay RW. Congenital valvular obstruction of prostatic urethra. Surg Gynecol Obstet 1929; 48: 509–535.

2. Hopkins HH. British patent 954,629 and U.S. patent 1960, 3,257,902.

3. Pearle MS, Lingeman JE, Leveillee R et al. Pros­pective, randomized trial comparing shockwave lithotripsy and ureteroscopy for lower pole caliceal calculi 1cm or less. J Urol 2005; 173(6): 2005–2009.

4. Clayman M, Uribe CA, Eichel L et al. Comparison of guide wires in urology. Which, when and why? J Urol 2004; 171 (6 Pt 1): 2146–2150.

5. Ng YH, Somani BK, Dennison A et al. Irrigant flow and intrarenal pressure during flexible ureteroscopy: the effect of different access sheaths, working channel instruments, and hydrostatic pressure. J Endourol 2010; 24(12): 1915–1920.

6. Delvecchio FC, Auge BK, Brizuela RM et al. Asses­sment of stricture formation with the ureteral access sheath. Urology 2003; 61(3): 518–522.

7. Vanlangendonck R, Landman J. Ureteral access strategies: pro-access sheath. Urol Clin North Am 2004; 31(1): 71–81.

8. Stern JM, Yiee J, Park S. Reviews in Endourology Safety and Efficacy of Ureteral Access Sheaths. J Endourol 2007; 21(2): 119–123.

9. Rapoport D, Perks AE, Teichman JMH. Ureteral access sheath use and stenting in ureteroscopy: effect on unplanned emergency room visits and cost. J Endourol 2007; 21(9): 993–997.

10. Goodman TM. Ureteroscopy with paediatric cystoscope in adults. Urology 1997; 9(4): 394.

11. Lyon ES, Kyker JS, Schoenberg HW. Transurethral ureteroscopy in women: A ready addition to the urological armamentarium. J Urol 1978; 119(1): 35–36.

12. Takagi T, Go T, Takayasu H et al. Fiberoptic pyelo­ureteroscope. Surgery 1971; 70(5): 661–663.

13. Pérez-Castro Ellendt E, Martínez-Piñeiro JA. Trans­urethral ureteroscopy. A current urological procedure [Article in Spanish]. Arch Esp Urol 1980; 33(5): 445–460.

14. Bagley DH, Huffman JL, Lyon ES. Combined rigid and flexible ureteropyeloscopy. J Urol 1983; 130(2): 243–244.

15. Multescu R, Geavlete B, Georgescu D et al. Conventional Fiberoptic Flexible Ureteroscope Versus Fourth Generation Digital Flexible Ureteroscope: A Critical Comparison. J Endourol 2010; 24(1): 17–21.

16. Shvarts O, Perry KT, Goff B et al. Improved functional deflection with a dual-deflection flexible ureteroscope. J Endourol 2004; 18(2): 141–144.

17. Holley PG, Sharma SK, Perry KT et al. Assessment of novel ureteral occlusion de- vice and comparison with Stone Cone in pre- vention of stone fragment migration during lithotripsy. J Endourol 2005; 19(2): 200–203.

18. Patel A. Lower calyceal occlusion by autologous blood clot to prevent stone fragment reaccumulation after retrograde intra-renal surgery for lower calyceal stones: first experience of a new technique. J Endourol 2008; 22(11): 2501–2506.

19. Natalin R, Xavier K, Okeke Z et al. Impact of obesity on ureteroscopic laser lithotripsy of urinary tract calculi. Int Braz J Urol 2009; 35(1): 36–42.

20. Wheat JC, Roberts WW, Wolf JS Jr. Multi-session retrograde endoscopic lithotripsy of large renal cal-culi in obese patients. Can J Urol 2009; 16(6): 4915–4920.

21. Turna B, Stein RJ, Smaldone MC et al. Safety and efficacy of flexible ureterorenoscopy and holmium:YAG lithotripsy for intrarenal stones in anticoagulated cases. J Urol 2008; 179(4): 1415–1419.

22. Riley JM, Stearman L, Troxel S. Retrograde urete­ro­scopy for renal stones larger than 2.5 cm. J Endourol 2009; 23(9): 1395–1398.

23. Breda A, Ogunyemi O, Leppert JT et al. Flexible Ureteroscopy and Laser Lithotripsy for Multiple Unilateral Intrarenal Stones. Eur Urol 2009; 55(5): 1190–1196.

24. Mariani AJ. Combined Electrohydraulic and Holmium:YAG Laser Ureteroscopic Nephrolithotripsy of Large (Greater Than 4 cm) Renal Calculi. J Urol 2007; 177(1): 168–173.

25. John TT, Razdan S. Adjunctive tamsulosin impro­ves stone free rate after ureteroscopic lithotripsy of large renal and ureteric calculi: a prospective randomized study. Urology 2010; 75(5): 1040–1042.

26. Patel A, Fuchs GJ. Expanding the horizons of SWL through adjunctive use of retrograde intrarenal surgery: new techniques and indications. J Endourol 1997; 11(1): 33–36.

27. Marguet CG, Springhart WP, Tan YH et al. Simul­taneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi. BJU Int 2005; 96(7): 1097–1100.

28. Nabi G, Cook J, N'Dow J et al. Outcomes of sten­ting after uncomplicated ureteroscopy: systematic review and meta-analysis. BMJ 2007; 334(7593): 572.

29. Rane A, Saleemi A, Cahill D et al. Have stent-related symptoms anything to do with placement technique? J Endourol 2001; 15(7): 741–745.

30. Deliveliotis C, Chrisofos M, Gougousis E et al. Is there a role for alpha1-blockers in treating double-J stent-related symptoms? Urology 2006; 67(1): 35–39.

31. Damiano R, Autorino R, De Sio M et al. Effect of tamsulosin in preventing ureteral stent-related morbidity: a prospective study. J Endourol 2008; 22(4): 651–656.

32. Desai MM, Aron M, Gill IS et al. Flexible robotic retrograde renoscopy: description of novel robotic device and preliminary laboratory experience. Urology 2008; 72(1): 42–46.

33. Desai MM, Grover R, Aron M et al. Robotic flexible ureteroscopy for renal calculi: initial clinical experience. J Urol 2011; 186(2): 563–568.

34. Langen PH, Karypiadou M, Steffens J. Uretero­scopy under intravenous analgesia with remifentanil. Urologe A 2004; 43(6): 689–697.

35. Park HK, Paick SH, Oh SJ et al. Ureteroscopic lithotripsy under local anesthesia: Eur Urol 2004; 45(5): 670–673.

Labels
Paediatric urologist Urology

Article was published in

Urological Journal

Issue 1

2012 Issue 1

Most read in this issue

This topic is also in:


Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account