To evaluate the safety and feasibility of ureteroscopy plus elective double-J stent as an outpatient procedure in an unselected population with regard to the treatment for ureteral calculi and to present a multivariate analysis of factors predict hospitalization.
Ureteroscopy was performed as an outpatient procedure on 308 consecutive patients with ureteral stones. Contraindication for day case surgery was the only exclusion criteria from the study. All causes that led to immediate hospitalization were recorded; at the same time, all causes of hospitalization that occurred within 72 h from the procedure were also recorded and included in the final analysis.
The overall stone-free rate and the rate of hospitalization were 94.5 and 9.7% respectively. Intraoperative complications were observed in 16 patients (5.1%). In terms of the variables related to hospitalization, the univariate analysis showed a statistical significant association between the American Society of Anesthesiologists (ASA) score (p < 0.001) and operative time (p = 0.018). At multivariate analysis, the only independent factor predictor of hospitalization was the ASA score (p < 0.001).
In our experience, semirigid ureteroscopy is a safe and effective treatment that is independent of intraoperative local conditions or stone size. Elective Double-J stenting avoids major complications as the first reason for hospitalization. We suggest that ASA score > 2 should be taken into account when ureterorenoscopy is planning as an outpatient procedure.
Urologia internationalis. 2018 Nov 14 [Epub ahead of print]
Stefano Salciccia, Alessandro Sciarra, Federico Pierella, Pier Paolo Leoncini, Patrizia Vitullo, Milena Polese, Martina Maggi, Giacomo Perugia, Pierangelo Di Marco, Gian Piero Ricciuti
Department of Gynecology-Obstetrics and Urology, Sapienza University of Rome, Rome, ., Department of Gynecology-Obstetrics and Urology, Sapienza University of Rome, Rome, Italy., Laboratory of Angiogenesis Department of Oncohematology "Bambino Gesu'" Children Hospital, Rome, Italy., Research Laboratories, Oncohematology Department, IRCCS Bambino Gesù Children's Hospital, Rome, Italy., Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic, and Geriatric Sciences, Sapienza University, Rome, Italy.