Objective: To determine the impact of duration of ureteroscopy for urolithiasis on complication rates (CRs) of the procedure. Methods: A retrospective analysis of 2,010 patients, treated between 2006 and 2011, was done. The operation time (OT) and the occurrence of complications were compared. Results: The overall CR was 14.3% [298 complications, minor complications (Clavien I-II) 91.7%]. The median OT was 35 min [interquartile range (IQR) 20-61]. The OT differed significantly between those without complications [34 min (IQR 20-60)] and those with complications [45 min (IQR 25-76)] (p < 0.0001). The correlation between the OT and the occurrence of complications (r = -0.009648, p < 0.0001) was very weak and passed the level of significance (r = 0.2). The effect size was of minor relevance (Cohen's d = 0.27972). Conclusions: Longer OT correlates significantly with a higher CR. The effect is however shown to be minor and the overall rate of complications, especially severe ones, is low.

Keywords:
Ureteroscopy, Complications, Urolithiasis
1.
Romero V, Akpinar H, Assimos DG: Kidney stones: a global picture of prevalence, incidence, and associated risk factors. Rev Urol 2010;12:e86-e96.
2.
AK Harnsteine S2-Leitlinie: Diagnose, Therapie und Metaphylaxe der Urolithiasis, AWMF-Registernummer 043/025, Stand 02/2009.
3.
Scales CD Jr, Smith AC, Hanley JM, Saigal CS; Urologic Diseases in America Project: Prevalence of kidney stones in the United States. Eur Urol 2012;62:160-165.
4.
Türk C, Knoll T, Petrik A, Sarica K, Straub M, Seitz C: European Association of Urology Guidelines on Urolithiasis. Available at www.uroweb.org/gls/pdf/20_Urolithiasis_LR%20March%2013%202012.pdf.
5.
Bader MJ, Eisner B, Porpiglia F, Preminger GM, Tiselius HG: Contemporary management of ureteral stones. Eur Urol 2012;61:764-772.
6.
Matlaga BR, Jansen JP, Meckley LM, Byrne TW, Lingeman JE: Treatment of ureteral and renal stones: a systematic review and meta-analysis of randomized, controlled trials. J Urol 2012;188:130-137.
7.
de la Rosette J, Denstedt JD, Geavlete PA, Keeley F, Matsuda T, Pearle MS, Preminger GM, Traxer O: The Clinical Research Office of the Endourological Society Ureteroscopy Global Study: indications, complications, and outcomes in 11,885 patients. J Endourol 2014;28:131-139.
8.
Mandal S, Goel A, Singh MK, Kathpalia R, Nagathan DS, Sankhwar SN, Singh V, Singh BP, Sinha RJ, Dalela D: Clavien classification of semirigid ureteroscopy complications: a prospective study. Urology 2012;80:995-1001.
9.
El-Nahas AR, El-Tabey NA, Eraky I, Shoma AM, El-Hefnawy AS, El-Assmy AM, Soliman S, Youssef RF, El-Kenawy MR, Shokeir AA, El-Kappany HA: Semirigid ureteroscopy for ureteral stones: a multivariate analysis of unfavorable results. J Urol 2009;181:1158-1162.
10.
Schuster TG, Hollenbeck BK, Faerber GJ, Wolf JS Jr: Complications of ureteroscopy: analysis of predictive factors. J Urol 2001;166:538-540.
11.
Leijte JA, Oddens JR, Lock TM: Holmium laser lithotripsy for ureteral calculi: predictive factors for complications and success. J Endourol 2008;22:257-260.
12.
Abdelrahim AF, Abdelmaguid A, Abuzeid H, Amin M, Mousa el-S, Abdelrahim F: Rigid ureteroscopy for ureteral stones: factors associated with intraoperative adverse events. J Endourol 2008;22:277-280.
13.
Fuganti PE, Pires S, Branco R, Porto J: Predictive factors for intraoperative complications in semirigid ureteroscopy: analysis of 1,235 ballistic ureterolithotripsies. Urology 2008;72:770-774.
14.
Breda A, Ogunyemi O, Leppert JT, Lam JS, Schulam PG: Flexible ureteroscopy and laser lithotripsy for single intrarenal stones 2 cm or greater - is this the new frontier? J Urol 2008;179:981-984.
15.
Riley JM, Stearman L, Troxel S: Retrograde ureteroscopy for renal stones larger than 2.5 cm. J Endourol 2009;23:1395-1398.
16.
Bader MJ, Gratzke C, Walther S, Weidlich P, Staehler M, Seitz M, Sroka R, Reich O, Stief CG, Schlenker B: Efficacy of retrograde ureteropyeloscopic holmium laser lithotripsy for intrarenal calculi >2 cm. Urol Res 2010;38:397-402.
17.
Herrera-Gonzalez G, Netsch C, Oberhagemann K, Bach T, Gross AJ: Effectiveness of single flexible ureteroscopy for multiple renal calculi. J Endourol 2011;25:431-435.
18.
Breda A, Ogunyemi O, Leppert JT, Schulam PG: Flexible ureteroscopy and laser lithotripsy for multiple unilateral intrarenal stones. Eur Urol 2009;55:1190-1197.
19.
Dindo D, Demartines N, Clavien PA: Classification of surgical complications: a new proposal with evaluation in a cohort of 6,336 patients and results of a survey. Ann Surg 2004;240:205-213.
20.
Netsch C, Knipper S, Bach T, Herrmann TRW, Gross AJ: Impact of preoperative ureteral stenting on stone-free rates of ureteroscopy for nephroureterolithiasis: a matched-paired analysis of 286 patients. Urology 2012;80:1214-1219.
21.
Traxer O, Dubosq F, Jamali K, Gattegno B, Thibault P: New-generation flexible ureterorenoscopes are more durable than previous ones. Urology 2006;68:276-279.
22.
Perez Castro E, Osther PJ, Jinga V, Razvi H, Stravodimos KG, Parikh K, Kural AR, de la Rosette JJ; CROES Ureteroscopy Global Study Group: Differences in ureteroscopic stone treatment and outcomes for distal, mid-, proximal, or multiple ureteral locations: the Clinical Research Office of the Endourological Society ureteroscopy global study. Eur Urol 2014;66:102-109.
23.
Sugihara T, Yasunaga H, Horiguchi H, Nishimatsu H, Kume H, Ohe K, Matsuda S, Fushimi K, Homma Y: A nomogram predicting severe adverse events after ureteroscopic lithotripsy: 12,372 patients in a Japanese national series. BJU Int 2013;111:459-466.
24.
Opondo D, Tefekli A, Esen T, Labate G, Sangam K, De Lisa A, Shah H, de la Rosette J; CROES PCNL study group: Impact of case volumes on the outcomes of percutaneous nephrolithotomy. Eur Urol 2012;62:1181-1187.
25.
Gross AJ, Netsch C, Knipper S, Hölzel J, Bach T: Complications and early postoperative outcome in 1,080 patients after thulium vapoenucleation of the prostate: results at a single institution. Eur Urol 2013;63:859-867.
26.
Rubenstein RA, Zhao LC, Loeb S, Shore DM, Nadler RB: Prestenting improves ureteroscopic stone-free rates. J Endourol 2007;21:1277-1280.
27.
Chu L, Sternberg KM, Averch TD: Preoperative stenting decreases operative time and reoperative rates of ureteroscopy. J Endourol 2011;25:751-754.
28.
Traxer O, Thomas A: Prospective evaluation and classification of ureteral wall injuries resulting from insertion of a ureteral access sheath during retrograde intrarenal surgery. J Urol 2013;189:580-584.
29.
Schoenthaler M, Buchholz N, Farin E, Ather H, Bach C, Bach T, Denstedt JD, Fritsche HM, Grasso M, Hakenberg OW, Herwig R, Knoll T, Kuehhas FE, Liatsikos E, Liske P, Marberger M, Osther PJ, Santos JM, Sarica K, Seitz C, Straub M, Traxer O, Trinchieri A, Turney B, Miernik A: The Post-Ureteroscopic Lesion Scale (PULS): a multicenter video-based evaluation of inter-rater reliability. World J Urol 2014;32:1033-1040.
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2015
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