The general prevalence of bilateral urolithiasis has risen to 15% and bilateral non-simultaneous treatment has been reported to have good outcomes. The objective of this study was to evaluate the effectiveness and safety of simultaneous bilateral endoscopic surgery (SBES).
An international multicenter analysis was performed between May 2015 and December 2017. All patients with bilateral stone disease that underwent SBES were included. Patients were treated under general anesthesia in either the supine or lithotomy position. Demographic, clinical, intraoperative and postoperative data were analyzed.
A total of 47 patients were included. Mean age was 53.8 years and 70% of the patients were males. The mean American Society of Anesthesiology (ASA) score was 2. The mean diameter of right- and left-sided stones was 29.43 mm (2-83 mm) and 31.15 (4-102 mm), respectively. Staghorn stones were treated in 18 cases (8 right-sided and 10 left-sided), four of them were defined as complete staghorn. The procedures performed were 42 cases of bilateral URS and PCNL and ureteroscopy. Additionally, 5 bilateral flexible ureteroscopy (fURS) cases were described. Intraoperative complications occurred in five patients: four of them were classified as Clavien-Dindo (CD) I and one as CD II. Postoperatively, there were two cases with CD I, 6 with CD II and one CD IIIa.The stone-free status was 70%. Residual stones (30%) were detected only on the side treated for high-volume (complete) staghorn calculi.
SBES is a feasible, effective and safe procedure. It may potentially avoid repeated anesthetic sessions as needed for staged procedures and reduce the length of patients’ hospital stay.
Central European journal of urology. 2019 May 30 [Epub]
Oriol Angerri, Olga Mayordomo, Andres Koey Kanashiro, Felix Millan-Rodriguez, Francisco Maria Sanchez-Martin, Sung-Yo Cho, Eran Schreter, Mario Sofer, Saeed Bin-Hamri, Ahmed Alasker, Yiloren Tanidir, Tarik Emre Sener, Panagiotis Kalidonis, Joan Palou-Redorta, Esteban Emiliani
Department of Urology, Fundació Puigvert, Universitat Autonoma de Barcelona, Barcelona, Spain., Department of Urology, Seoul Metropolitan Government – Seoul National University (SMG-SNU) Boramae Medical Center, South Korea., Tel-Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel., Department of Urology, King Abdulaziz National Guard Hospital, Riyadh, Saudi Arabia., Department of Endourology and Stones, Marmara University, Istanbul, Turkey., ESUT-YAU endourology working group., PETRA group.