Is a contrast study really necessary prior to ureteroscopy?

• Published in: Brazilian journal of medical and biological research 2016-01, Vol.49 (1), p.e4855-e4855
• Main Authors: Bayrak, O, Demirbas, A, Doluoglu, O G, Karakan, T, Resorlu, B, Kardas, S, Tepeler, A, Tangal, S, Adanur, S, Celik, O
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; BIOLOGY; Child; Child, Preschool; Clinical Investigation; Complications and side effects; Computed tomography; Contrast Media; CT imaging; Female; Humans; Imaging; Incidence; Infant; Intraoperative Complications - epidemiology; Intravenous urography; Lithotripsy; Lithotripsy - adverse effects; Lithotripsy - methods; Male; MEDICINE, RESEARCH & EXPERIMENTAL; Middle Aged; Preoperative Period; Radionuclide Imaging - methods; Retrospective Studies; Statistics, Nonparametric; Stone; Tomography, X-Ray Computed - methods; Ureteral Calculi - diagnosis; Ureteral Calculi - surgery; Ureteroscopy; Ureteroscopy - adverse effects; Ureteroscopy - methods; Urography - methods; Young Adult
• ISSN: 0100-879X; 1414-431X; 1414-431X
• DOI: 10.1590/1414-431X20154855

This study aimed to evaluate the effect of preoperative imaging techniques on the success and complication rates of ureteroscopy. We performed a retrospective analysis of 736 patients (455 males and 281 females), with a mean age of 45.5±15.2 years (range, 1-88 years), who underwent rigid ureteroscopic procedures for removal of ureteral stones. Patients were divided into 4 groups according to the type of imaging modality used: group I, intravenous urography (n=116); group II, computed tomography (n=381); group III, computed tomography and intravenous urography (n=91), and group IV, ultrasonography and abdominal plain film (n=148). Patients' demographics, stone size and location, prior shock wave lithotripsy, lithotripsy technique, operation time, success rate, and rate of intraoperative complications were compared among the groups. There were no significant differences in success and complication rates among the groups. The stone-free rate after primary ureteroscopy was 87.1% in group I, 88.2% in group II, 96.7% in group III, and 89.9% in group IV (P=0.093). The overall incidence of intraoperative complications was 11.8%. According to the modified Satava classification system, 6.1% of patients had grade 1, 5.1% had grade 2, and 0.54% had grade 3 complications. Intraoperative complications developed in 12.1% of patients in group I, 12.6% of patients in group II, 7.7% of patients in group III, and 12.2% of patients in group IV (P=0.625). Our findings clearly demonstrate that ureteroscopic treatment of ureteral stones can be safely and effectively performed with no use of contrast study imaging, except in doubtful cases of anatomical abnormalities.