Comparison of different ureteroscope sizes in treating ureteral calculi in adult patients

Objective: To compare the success and complication rates of a 4.5-6.5F semirigid ureteroscope (S-URS) with an 8.5-11.5F S-URS in treating ureteral stones in adult patients.

Materials and methods: Fifty-two patients with ureteral stones, who were treated with 4.5-6.5F S-URS (group 1) and 52 patients who were treated with 8.5-11.5F S-URS (group 2) were compared retrospectively using a matched-pair analysis. The size, lateralization, location, and impaction of the stones and also the patient age, gender, body mass index, and the presence of hydronephrosis were used as the matching parameters. The stones were fragmented with Holmium-YAG laser.

Results: The matching parameters were comparable between the 2 groups. The stone-free rates were 88.5% in group 1 and 84.6% in group 2 (P = .566) after a single procedure. The mean operative times for groups 1 and 2 were 32.7 ± 5.8 and 30.2 ± 5.4 minutes, respectively (P = .06). Postoperative hematuria was detected in 1.9% and 13.5% of patients in groups 1 and 2 (P = .027). Ureteral balloon dilation was needed in 1.9% and 15.4% of patients in groups 1 and 2, respectively (P = .015). Mucosal injury was observed in 1.9% and 13.5% of the patients in groups 1 and 2, respectively (P = .027). No major complications were noted in either group.

Conclusion: Although the stone-free rates and operative times were similar between the 2 groups, a 4.5-6.5F ureteroscope can reduce the need for ureteral balloon dilation and some minor complications, such as mucosal injury and postoperative hematuria, in adult patients.