URETEROSCOPY – AS EMERGENCY TREATMENT PERFORMED FOR URETERAL STONES IN SOLITARY KIDNEY

Acute renal failure caused by ureteral stones represents one of the most important urologic emergencies. Patients with solitary kidney need periodic evaluation and increased attentions. The aim of this study is to evaluate the effectiveness of first choice ureteroscopy as definitive treatment for ureteral calculi in patients with solitary kidney. A series of 43 patients with solitary kidney for specific reasons who underwent primarily ureteroscopy were analyzed from 1 January 2018 to 31 October 2019 at “Prof. Dr. Th. Burghele” Clinical Hospital in Bucharest. All patients were imagistic evaluated with abdominal ultrasound, KUB and intravenous urography when possible. Blood tests and urine tests were analyzed for each case. There were excluded patients with fever or altered clinical status. We enrolled 25 men and 18 females with a mean age of 45.67 years old. The major symptoms at presentation were flank pain and oligo-anuria. Based on the imagistics we estimated a mean stone size about 6.74 mm. Frequently stones were located at pelvic level in 79.06% flowed by lumbar 16.27% and ureteropelvic junction 4.65% The stone free rate was 97.67% without major complications. All cases were standard ureteral stented for 3 weeks and were extracted after reevaluation. More and more studies consider that ureteroscopy as first line management can be a valid option instead of placing a nephrostomy tube or double J stent.