Postoperative Complication after treatment of upper ureteral stone to ureteropelvic junction stone compare between semi-rigid URS and flexible URS in Rayong Hospital
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Abstract
Background : Urinary tract stones are a common urological condition with a worldwide prevalence of 1-20%. The primary cause is abnormal renal excretion of minerals. The current standard treatment is ureteroscopy, which has shown high efficacy and low complication rates, particularly for ureteral stones. However, when considering upper ureteral and ureteropelvic junction stones separately, there is limited research to definitively determine whether rigid or flexible ureteroscopy offers superior treatment outcomes and lower complication rates.
Objective : Comparing postoperative complications of ureteroscopy after upper ureteral to ureteropelvic junction stone treatment using rigid and flexible ureteroscopes at Rayong Hospital.
Methods : The study employs a retrospective descriptive study design, collecting data from patients who underwent ureteroscopy at Rayong Hospital between January 1, 2018, and December 31, 2021, by retrieving retrospective data from the hospital database. The data collection form includes general patient information, characteristics of the stones, treatment outcomes, successful outcomes, and treatment complications. Data analysis involves descriptive statistics, percentages, means, standard deviations, chi-square and Fisher's exact test.
Results : The study found a total of 61 patients, comprising 30 females (49.2%) and 31 males (50.8%), with an average age of 51.9 years. Most patients had comorbidities such as metabolic syndrome (diabetes, hypertension, hyperlipidemia, gout, obesity) (45.7%). The average stone size was 16.2 ± 11.7 millimeters. The success rate of stone fragmentation in the ureter using rigid ureteroscopy was 63.3%, while the success rate using flexible ureteroscopy was 67.7%, with flexible ureteroscopy showing a 3.49 times higher success rate than rigid ureteroscopy. The overall immediate complication rate was 4.9%, and the overall complication rate post-surgery was 13.1%. Comparing immediate complications between rigid and flexible ureteroscopy, the incidence rates were 3.3% and 6.5%, respectively. For postoperative complications between rigid and flexible ureteroscopy, the incidence rates were 16.7% and 9.7%, respectively.
Conclusion : rigid and flexible ureteroscopy for treating urinary stones is a safe procedure with good treatment outcomes and low complication rates.
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