Same session bilateral ureteroscopy is safe and efficacious

Purpose: Bilateral ureteroscopy can be done in 1 sitting, obviating the need for multiple procedures. We analyzed our experience with same session bilateral ureteroscopy to determine its safety and efficacy.

Materials and methods: In this retrospective study of a 9-year period at Emory University Hospital 1,575 consecutive ureteroscopic procedures were done, of which 95 (6.0%) were done as same session bilateral ureteroscopy, thus constituting our study cohort. Bilateral procedures were performed for urolithiasis in 71 cases, urothelial carcinoma in 9, ureteral stricture in 2 and another indication in 13. Patients were followed at least 1 month postoperatively to evaluate procedural success and assess perioperative complications.

Results: Mean age of the 44 male and 40 female patients was 49.8 years. Multiple procedures were done in 9 patients and same session bilateral ureteroscopy was done in 93 of 95 (98%). Intraoperative and postoperative (greater than 1 month) bilateral stone-free rates were 86% and 64%, respectively. The mean change in serum creatinine postoperatively was 0.02 mg/dl (range -0.9 to 1.3). No patient had acute postoperative azotemia. Postoperative complications in 9.7% of patients included pain necessitating an emergency room visit in 4, pyelonephritis/urinary tract infection in 2, and urinary retention, intractable stent pain leading to early removal and urosepsis/death in 1 each.

Conclusions: Same session bilateral ureteroscopy is efficacious and safe to evaluate and treat upper tract pathology. While most complications are minor, they may be higher than that typically reported for unilateral ureteroscopic procedures.