BJUI compass · 2026
Patient satisfaction and scope size of flexible ureteroscopy for upper urinary stones: A comparative study, multivariate analysis and subjective and objective evaluations.
СтатьяНазвание и аннотация: Перевод в очереди
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Hekal Ihab A, Hekal Yousef I, Hekal Jana I, Memari Abdulla Al
Аннотация
OBJECTIVE: This study aimed to evaluate subjectively and objectively the use of the slimmest scope, 7.5 Fr, on patient quality of life and outcome for upper urinary stones (UUS) treated by flexible ureteroscopy and to study the impact of ureteric stent insertion and operative techniques on patient satisfaction.
METHODS: Between January 2024 and October 2025, 120 cases with UUS met our inclusion criteria: stone burden > 7 mm (single or multiple), radio-opaque stone, no UTI and not more than mild hydronephrosis preoperatively. Two endoscopic techniques were encountered. An equal number of cases were operated on using a scope of 7.5 Fr (Group A) and 9.5 Fr (Group B). The comparisons of patient factors included age and body mass index (BMI). Stone size, number and laterality were analysed. Operative factors included ureteral dilatation, stent insertion and procedure duration. Post-operative stent, its duration, pain level, dark urine (possible significant haematuria) or dysuria (possible infection), retained stone or other post-operative complications were assessed.
RESULTS: Both scope groups were demographically insignificant. The stone location and side were comparable. Operative details had a nearly insignificant comparison. Group A had a long operative time. Stent insertion was higher in Group B. Subjectively, the dark urine symptom was reported in 37 and 23 cases in Groups A and B, respectively (p < 0.05). Interestingly, 11 cases needed opioid injections for post-operative colic in Group A (p = 0.008). The stone-free rate was 89.2% and 91.7% in Groups A and B, respectively (p = 0.487). All stented cases had mild storage lower urinary symptoms. No major surgical complications were reported.
CONCLUSION: Scope size has no impact on patient post-operative outcome. Interestingly, a long operative time with a small scope was observed. Ureteral dilation and stent insertion cases have urinary post-operative symptoms. A nonstent procedure is advised in noncomplicated cases (Hekal's criteria).
METHODS: Between January 2024 and October 2025, 120 cases with UUS met our inclusion criteria: stone burden > 7 mm (single or multiple), radio-opaque stone, no UTI and not more than mild hydronephrosis preoperatively. Two endoscopic techniques were encountered. An equal number of cases were operated on using a scope of 7.5 Fr (Group A) and 9.5 Fr (Group B). The comparisons of patient factors included age and body mass index (BMI). Stone size, number and laterality were analysed. Operative factors included ureteral dilatation, stent insertion and procedure duration. Post-operative stent, its duration, pain level, dark urine (possible significant haematuria) or dysuria (possible infection), retained stone or other post-operative complications were assessed.
RESULTS: Both scope groups were demographically insignificant. The stone location and side were comparable. Operative details had a nearly insignificant comparison. Group A had a long operative time. Stent insertion was higher in Group B. Subjectively, the dark urine symptom was reported in 37 and 23 cases in Groups A and B, respectively (p < 0.05). Interestingly, 11 cases needed opioid injections for post-operative colic in Group A (p = 0.008). The stone-free rate was 89.2% and 91.7% in Groups A and B, respectively (p = 0.487). All stented cases had mild storage lower urinary symptoms. No major surgical complications were reported.
CONCLUSION: Scope size has no impact on patient post-operative outcome. Interestingly, a long operative time with a small scope was observed. Ureteral dilation and stent insertion cases have urinary post-operative symptoms. A nonstent procedure is advised in noncomplicated cases (Hekal's criteria).