Login to Access Video or Poster Abstract: MP50-18
Sources of Funding: None

Introduction

While single session bilateral ureteroscopy (URS) (SSBU) has the advantage of one anesthetic procedure, some may pursue a staged approach due to the potential higher risk of complications and patient discomfort with two ureteral stents. The aim of this series is to compare outcomes of patients undergoing SSBU to those undergoing staged URS for bilateral nephrolithiasis.

Methods

We retrospectively identified patients undergoing SSBU and staged URS for nephrolithiasis between September 2007 and January 2014. Preoperative characteristics, intraoperative techniques, and postoperative outcomes were compared. Stone burden was calculated as cumulative stone diameter. Residual stone fragments were defined as any stone visible on postoperative imaging.

Results

Sixty-three nonconsecutive patients underwent SSBU and 37 underwent staged URS. Patients undergoing SSBU had significantly more stones in mid pole calyces (28% versus 16%, P = 0.0008) and the renal pelvis (5% versus 2%, P = 0.048), though both groups had similar stone burden based on cumulative maximal diameter (Table 1). Patients undergoing SSBU had longer operative time when compared to any single stage URS, however, total operative time was significantly longer for staged URS (139 versus 86 minutes, P < 0.0001) (Table 1). Patients undergoing staged URS were more likely to require laser lithotripsy per renal unit (RU) (99% versus 71%, P = 0.0001) and have a ureteral stent placed at the end of the procedure (96% versus 81% RUs, P = 0.003). There were no significant differences in complications, emergency room (ER) visits, need for additional procedures, or stone free rates (SFR).

Conclusions

SSBU is safe and effective with overall shorter operative times and similar SFR compared to staged URS. For patients with bilateral nephrolithiasis, urologists should strongly consider SSBU to limit anesthetic exposure, overall operative time, and health care costs.

Funding

None