Introduction: We analyze our recent results and discuss the advantages and disadvantages of bilateral single-session ureterorenoscopy (URS) for bilateral ureteral stones. Patients and Methods: 55 patients underwent URS with pneumatic lithotripsy (PL) for bilateral stones. 61 (55.5%), 28 (25.4%) and 21 (19.1%) stones were located in the lower, middle and upper ureter, respectively. Results: Of the 110 stones, 99 (90.0%) were fragmented in a single procedure. The stone clearance rate was 94.5% after the second session. The stone clearance rates with regard to stone location were 71.4, 89.3 and 96.7% for the upper, middle and lower ureter, respectively. An analysis of the clearance rates based on location demonstrated that lower ureteric stones were more successfully removed than upper ureteric stones (96.7 vs.71.4%, p = 0.003). Conclusion: Bilateral single-session URS with PL is a highly effective treatment modality for bilateral ureteral stones. The success rate of PL is affected by stone size and location.

Keywords:
Bilateral, Ureteral stones, Ureterorenoscopy, Pneumatic lithotripsy
1.
Wirtz P, Krambeck AE, Handa SE, Terry C, Lingeman JE: Contralateral ureteroscopy performed at percutaneous nephrolithotomy: a unique evaluation of stone-free rates. J Urol 2010;184:2378–2382.
2.
Honeck P, Hacker A, Alken P, Michel MS, Knoll T: Shock wave lithotripsy versus ureteroscopy for distal ureteral calculi: a prospective study. Urol Res 2006;34:190–192.
3.
Anagnostou T, Tolley D: Management of ureteric stones. Eur Urol 2004;45:714–721.
4.
Wu CF, Shee JJ, Lin WY, Lin CL, Chen CS: Comparison between extracorporeal shock wave lithotripsy and semirigid ureterorenoscope with holmium: YAG laser lithotripsy for treating large proximal ureteral stones. J Urol 2004;172:1899–1902.
5.
Camilleri JC, Schwalb DM, Eshghi M: Bilateral same session ureteroscopy. J Urol 1994;152:49–52.
6.
Dindo D, Demartines N, Clavien PA: Classification of surgical complications: a new proposal with evaluation in a cohort of a 6,336 patients and results of a survey. Ann Surg 2004;240:205–213.
7.
Raman J, Bagrodia A, Gupta A, Bensalah K, Cadeddu JA, Lotan Y, Pearle MS: Natural history of residual fragments following percutaneous nephrostolithotomy. J Urol 2009;181:1163–1168.
8.
Pearle MS, Lingeman JE, Leveillee R, Kuo R, Preminger GM, Nadler RB, Macaluso J, Monga M, Kumar U, Dushinski J, Albala DM, Wolf JS Jr, Assimos D, Fabrizio M, Munch LC, Nakada SY, Auge B, Honey J, Ogan K, Pattaras J, McDougall EM, Averch TD, Turk T, Pietrow P, Watkins S: Prospective, randomized trial comparing shock wave lithotripsy and ureteroscopy for lower pole caliceal calculi 1 cm or less. J Urol 2008;179(5 suppl):69–73.
9.
Gunlusoy B, Degirmenci T, Arslan M, Kozacioğlu Z, Nergiz N, Minareci S, Ayder AR: Bilateral single-session ureteroscopy with pneumatic lithotripsy for bilateral ureter stones: feasible and safe. Urol Int 2008;81:202–205.
10.
Osario L, Lima E, Soares J, Autorino R, Versos R, Lhamas A, Marcelo F: Emergency ureteroscopic management of ureteral stones: Why not? Urology 2007;69:27–31.
11.
Gurbuz ZG, Gonen M, Fazlıoglu A, Akbulut H: Ureteroscopy and pneumatic lithotripsy, followed by extracorporeal shock wave lithotripsy for the treatment of distal ureteral stones. Int J Urol 2002;9:441–444.
12.
Brito AH, Mitre AI, Srougi M: Ureteroscopic pneumatic lithotripsy of impacted ureteral calculi. Int Braz J Urol 2006;32:295–299.
13.
Halachmi S, Nagar M, Golan S, Ginesin Y, Meretyk S: Extracorporeal shock wave lithotripsy for large ureteral stones using HM3 lithotriptor. J Urol 2006;176:1449–1452.
14.
Kijuikai K, Halebian EG, Preminger MG, La Rosette J: Shock wave lithotripsy or ureteroscopy for the management of proximal ureteral calculi: an old discussion revisited. J Urol 2007;178:1157–1163.
15.
Lee YH, Tsai JY, Jiaan BP, Wu T, Yu CC: Prospective randomized trial comparing shock wave lithotripsy and ureteroscopic lithotripsy for management of large upper third ureteral stones. Urology 2006;67:480–484.
16.
Youssef RF, El-Nahas AR, El-Assmy AM, El-Tabey NA, El-Hefnawy AS, Eraky I, El-Kenawy MR, El-Kappany HA, Sheir KZ: Shock wave lithotripsy versus semirigid ureteroscopy for proximal ureteral calculi (<20 mm): a comparative matched-pair study. Urology 2009;73:1184–1187.
17.
Ather MH, Nazim SM, Sulaiman MN: Efficacy of semirigid ureteroscopy with pneumatic lithotripsy for ureteral stone surface area of greater than 30 mm2. J Endourol 2009;23:619–622.
18.
Kravchick S, Bunkin I, Stepnov E, Peled R, Agulansky L, Cytron S: Emergency extracorporeal shockwave lithotripsy for acute renal colic caused by upper urinary tract stones. J Endourol 2005;19:1–4.
19.
Gunlusoy B, Degirmenci T, Arslan M, Kozacioglu Z, Nergiz N, Minareci S, Ayder AR: Ureteroscopic pneumatic lithotripsy: is location of the stone important in decision making? J Endourol 2008;22:291–294.
20.
Chan VO, Buckley O, Persaud T, Torreggiani WC: Urolithiasis: how accurate are plain radiographs? Can Assoc Radiol J 2008;59:131–134.
21.
Johnston R, Lin A, Du J, Mark S: Comparison of kidney-ureter-bladder abdominal radiography and computed tomography scout films for identifying renal calculi. BJU Int 2009;104:670–673.
22.
Dixon AK, Dendy P: Spiral CT: how much does radiation dose matter? Lancet 1998;352:1082–1083.
23.
Schatloff O, Lindner U, Ramon J, Winkler HZ: Randomized trial of stone fragment active retrieval versus spontaneous passage during holmium laser lithotripsy for ureteral stones. J Urol 2010;183:1031–1036.
24.
Teichman JM, Vassar GJ, Bishoff JT, Bellman GC: Holmium:YAG lithotripsy yields smaller fragments than lithoclast, pulsed dye laser or electrohydraulic lithotripsy. J Urol 1998;159:17–23.
25.
Hollenbeck BK, Schuster TG, Faerber GJ, Wolf JS: Safety and efficacy of same-session bilateral ureteroscopy. J Endourol 2003;17:881–885.
26.
Deliveliotis C, Picramenos D, Alexopoulou K, Christofis I, Kostakopoulos A, Dimopoulos C: One-session bilateral ureteroscopy: is it safe in selected patients? Int Urol Nephrol 1996;28:481–484.
27.
Parker BD, Frederick RW, Reilly TP, Lowry PS, Bird ET: Efficiency and cost of treating proximal ureteral stones: shock wave lithotripsy versus ureteroscopy plus holmium:yttrium-aluminum-garnet laser. Urology 2004;64:1102–1106.
28.
Watson JM, Chang C, Pattaras JG, Ogan K: Same session bilateral ureteroscopy is safe and efficacious. J Urol 2011;185:170–174.
29.
Harmon WJ, Sershon PD, Blute ML, Patterson DE, Segura JW: Ureteroscopy: current practice and long-term complications. J Urol 1997;157:28–32.
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2012
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