[Flexible mini-ureteroscopy in diseases of the upper urinary tract: our experience]

Abstract

Objective: The aim of our work is to present our experience about the use of flexible mini-ureteroscope in the diagnosis and therapy of some upper urinary tract diseases.

Methods: We evaluated the data of 52 mini-ureteroscopy performed with 7.4 Fr instrument. The indications for ureteroscopy were: kidney stones (25 cases, 48.1%), filling defects (12 cases, 23.1%), positive cytology (5 cases, 9.6%), lateralising haematuria (8 casi, 15.4%), ureteropelvic junction obstruction (2 cases, 3.8%).

Results: There were no major complications during procedure. The stones were fragmented by 1.9 Fr electrohydraulic probe, by 200 and 365 m Holmium: YAG laser fiber or extracted by 0-Tip 3 Fr nitinol basket. The found papillary neoplasms were removed by basket or grasper and coagulated by laser fiber or 2 Fr electrode. The angiomas were coagulated by laser or 2 Fr electrode. The ureteropelvic junction was incised laterally by 365 m laser fiber or 3 Fr Rite-Cut. We interrupted the procedure only in 2 (3.8%) cases of lower pole kidney stones, because of lack of access with the laser fiber or other instruments.

Conclusion: Today, the flexible mini-ureteroscopy is the gold standard in the diagnosis of filling defects and lateralising haematurias. This technique can be therapeutic also for the angiomas and the low grade tumours. In case of kidney stones, this technique is a less invasive alternative compared to percutaneous nephrolithotomy in the treatment of caliceal stones resistant to SWL and is the only therapy for the extremely obese patients with bleeding diathesis.