Group B: Reterograde flexible ureteroscopy procedure (Retrograde FURS)
JJ
URETER, SECONDARY, COMPLICATIONS, POSTOPERATIVE COMPLICATIONS
Under spinal anesthesia, patients were put in the dorsal lithotomy position. Cystoscopy was performed and two guidewire were inserted in the targeted ureter. One of them was used as safety wire while the other was used for advancing the flexible URS upto the stone. Before the reterograde FURS maneuver, ureteral dilatation was done by balloon dilator if needed. Flexible URS was performed with a 9.5 Fr The LithoVue™ System-Boston Scientific. The stones were fragmented with the same laser device and settings as in group A. At the end of the procedure JJ stent was inserted in a reterograde manner.In both groups, the irrigation flow depended on gravity- based irrigation using saline and fragments were left for spontaneous passage after fragmentation into very tiny fragments.Both groups were compared as regard preoperative data (Age, Sex, stone characteristics), intra-operative data (Operative Time, Lithotripy time, Fluroscopy time, complications), and postoperative outcomes (stone free rate, complications, need for auxiliary procedure).Operative time was defined in both groups as the time from cystoscopy until JJ stent insertion. Two weeks after the procedure in both groups, all patients undergone non contrast CT before JJ stent removal to assess SFR which was defined as absence of residual fragment ˃ 3 mm.The primary endpoint of the present study was the SFR at 2 weeks. The secondary endpoint included intraoperative data (operative time, time for lithotripsy and fluoroscopy) and postoperative complications.