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Dr. Rabea Gomaa Sayed Omar :: Publications:

Fluoroless-ureteroscopy for definitive management of distal ureteral calculi: randomized controlled trial
Authors: Ahmed Mohey, MD, Mohamed Alhefnawy, MD, Mostafa Mahmoud, MD, Rabea Gomaa, MD, Tarek Soliman, MD, Shabieb Ahmed, MD, Yasser A. Noureldin, MD
Year: 2018
Keywords: ureteroscopy, fluoroscopy, management, ureteral calculi, outcomes
Journal: Not Available
Volume: Not Available
Issue: Not Available
Pages: Not Available
Publisher: Not Available
Local/International: International
Paper Link: Not Available
Full paper Rabea Gomaa Sayed Omar_Fluoroless Ureteroscopy for Definitive Management of Distal Ureteral Calculi Randomized Controlled Trial..pdf
Supplementary materials Not Available

MOHEY A, ALHEFNAWY M, MAHMOUD M, GOMAA R, SOLIMAN T, AHMED S, NOURELDIN YA. Fluoroless ureteroscopy for definitive management of distal ureteral calculi: randomized controlled trial. Can J Urol 2018;25(1):0000-0000. Introduction: To assess the conversion rate during fluoroless-ureteroscopy (URS) and evaluate the feasibility, safety, and efficacy of fluoroless-URS as a definitive management of distal ureteral calculi. Material and methods: Between May 2013 and August 2015, patients with radio-opaque distal ureteral calculi of ≤ 1 cm in size were randomized to undergo fluoroless- URS or standard URS. Patients with previous ureteral surgery, ureteral kinking, ureteral stricture, single kidney, additional proximal ureteral or renal calculi, uncontrolled coagulopathy, and/or congenital anomalies of the urinary tract were excluded. Patients’ demographics, stone characteristics, operative data, stone free status, and complications were compared between both groups. Results: Seventy-four cases in the fluoroless-URS group were compared with 80 cases in the standard-URS group. There was no significant difference in the baseline characteristics between both groups in terms of the mean patient’s age (28.8 ± 13.3 versus 29.5 ± 14.6 years; p = 0.76), body mass index (28.2 ± 33 versus 27.6 ± 2.3 kg/m2; p = 0.19), and stone size (7.2 ± 1.5 versus 7.3 ± 1.7 mm; p = 0.70), respectively. Furthermore, there was no significant difference in the outcome parameters between both groups in terms of operative time (42.4 ± 8.3 versus 40.3 ± 6.5 min; p = 0.08), stone free rate (93.2% versus 95%; p = 0.06), and overall complications (12.2% versus 8.75%; p = 0.08), respectively. There was significant difference between both techniques in terms of fluoroscopy time (p < 0.001). However, 6 (7.5%) fluoroless-URS cases necessitated the use of fluoroscopy intraoperatively. Conclusion: Ureteroscopic management of distal ureteral stones using fluoroless-URS technique could be feasible and safe, without radiation exposure for patients and medical personnel. However, fluoroscopy should always be available during fluoroless-URS.

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