Abstract: PD30-03
Sources of Funding: none

Introduction

We present an international experience with ipsilateral ureteroscopy (I-URS) for multiple ureteric and renal stones and bilateral URS (B-URS) for multiple, bilaterial ureteric and renal stones, using data collected from the Clinical Research Office of the Endourological Society (CROES) Ureteroscopy Global Study. Our objective was to compare I-URS and B-URS treatment characteristics and outcomes as well as the outcomes of multiple single-session stone treatments (I-URS and B-URS) with single stone URS treatments.

Methods

The CROES Ureteroscopy Global Study includes 114 centers in 32 countries. Patients undergoing B-URS, I-URS, and URS for a single stone were identified from January, 2010 to October, 2012. Intra-operative characteristics and post-operative outcomes were identified for each patient. Univariate regression analysis and inverse-probability weighted regression adjustment (IPWRA) analyses were used to compare outcomes and adjust for difference between centres.

Results

The CROES URS Global Study consists of 11885 patients. A total of 2153 (18.7%) patients were treated for multiple stones with 1880 (87.3%) and 273 (12.7%) patients undergoing I-URS and B-URS respectively. The univariate and IPWRA models for B-URS versus I-URS and multiple versus single stone treatments show that patients with B-URS and multiple stone treatments have lower stone free rates, higher re-treatment rates, and longer operating times compared to patients whom underwent I-URS and single stone treatment. There was no difference in complication rates between B-URS, I-URS, and single stone ureteroscopy.

Conclusions

This study represents the largest series of patients undergoing URS for bilateral and multiple ipsilateral stones. Our findings suggest a decrease in stone free rates, increased re-treatment rates, increased operating time and a longer hospital admission in patients treated for multiple stones. The treatment of multiple stones and B-URS is safe when compared to single stone and I-URS.

Funding

none