AUA 2017: Crossfire: Controversies in Urology: Ureteroscopy? Has the dust settled?

Boston, MA (UroToday.com) Dr. Traxer and Dr. Ghani presented their preference for performing ureteroscopy with dusting of stones. They argued that this can be performed rapidly with reduced costs from not opening disposables such as baskets, ureteral access sheaths, etc. They suggest that most patients can achieve stone free status and passage of very fine dust maybe done with minimal symptoms.

Dr. Best and Dr. Antonelli argued in favor of breaking up stones with the use of basketing to remove all possible fragments. They argued that this may produce less events in the future and the ability to tell your patients that they are indeed stone free after an invasive procedure. In terms of disposables, they argued that ureteral access sheaths can facilitate removal not only in basketing but even in patients that underwent dusting with the added benefit of lower intrarenal pressure and higher irrigation flow.

Dr. Traxer at the end of his presentation did suggest that perhaps the development of a vacuum with dusting would facilitate removal of dust to negate basketing. Perhaps a combination of the two is best with future development of baskets. The debate will continue.

Authors: Dr. Traxer & Dr. Ghani vs Dr. Antonelli & Dr. Best

Written By: Kam Kaler, MD, FRCSC for UroToday.com

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA

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