Ureterorenoscopic treatment of ureteral stones: influence of operator's experience and skill on the procedure outcome

Librenjak, Davor; Šitum, Marijan; Gugić, Dijana; Milostić, Kazimir; Duvnjak, Mario
February 2011
Croatian Medical Journal;Feb2011, Vol. 52 Issue 1, p55
Academic Journal
Aim To observe the influence of operating urologist's education and adopted skills on the outcome of ureterorenoscopy treatment of ureteral stones. Methods The study included 422 patients (234 men, 55.4%) who underwent ureterorenoscopy to treat ureteral stones at the Urology Department of Clinical Hospital Center Split, Croatia, between 2001 and 2009. All interventions were carried out with a semi-rigid Wolf ureteroscope and an electropneumatic generator used for lithotripsy. The operating specialists were divided into two groups. The first group included 4 urologists who had started learning and performing endoscopic procedures at the beginning of their specialization and the second group included 4 urologists who had started performing endoscopic procedures later in their careers, on average more than 5 years after specialization. Results Radiology tests confirmed that 87% (208/238) of stones were completely removed from the distal ureter, 54% (66/123) from the middle ureter, and 46% (28/61) from the proximal ureter. The first group of urologists completed significantly more procedures successfully, especially for the stones in the distal (95% vs 74%; P= 0.001) and middle ureter (66% vs 38%; P=0.002), and their patients spent less time in the hospital postoperatively. Conclusion Urologists who started learning and performing endoscopic procedures at the beginning of their specialization are more successful in performing ureteroscopy. It is important that young specialists receive timely and systematic education and cooperate with more experienced colleagues.


Related Articles

  • New polymer, robotics head advances in URS. Ferrandino, Michael // Urology Times;3/1/2009, Vol. 37 Issue 3, p8 

    The article presents two studies by the researchers at Great Britain-based East Surrey Hospital and the Cleveland Clinic urologists analyzing the effect of robotic ureteroscopic laser lithotripsy and BackStop polymer on ureteroscopic stone fragmentation. The study shows that in BackStop polymer,...

  • funding a hospitalist program which approach will you take? Greeno, Ron // hfm (Healthcare Financial Management);Aug2010, Vol. 64 Issue 8, p76 

    The article focuses on treating hospitalists as partners in order to increase the value of the hospitalist program and benefits the hospital's performance in the U.S. It mentions that hospitalists are physicians who focuses on the general care of hospitalized patients including nursing, imaging,...

  • Influence of Pelvicaliceal Anatomy on Stone Clearance After Flexible Ureteroscopy and Holmium Laser Lithotripsy for Large Renal Stones. Inoue, Takaaki; Murota, Takashi; Okada, Shinsuke; Hamamoto, Shuzo; Muguruma, Kouei; Kinoshita, Hidefumi; Matsuda, Tadashi // Journal of Endourology;Sep2015, Vol. 29 Issue 9, p998 

    Purpose: This study was performed to evaluate the impact of pelvicaliceal anatomy on stone clearance in patients with remnant fragments in the lower pole after flexible ureteroscopy and holmium laser lithotripsy (fURSL) for renal stones >15 mm. Patients and Methods: This retrospective study...

  • Subfascial Endoscopic Perforator Surgery Conserves Hospital Resources. Pigott, John P.; Beebe, Hugh G.; Salles-Cunha, Sergio X.; Kellermeyer, Gregory F.; Kriegel, Andrew V.; Schriefer, Cynthia; Dosick, Steven M.; Whaleun, Ralph C.; Steven S. Gale // Vascular Surgery;Sep/Oct1999, Vol. 33 Issue 5, p557 

    Innovations in the management of venous disorders have included subfascial endoscopic perforator surgery (SEPS). Information on resource utilization of this procedure is limited. Comparison of sequential cohorts of patients treated for leg venous hypertension by SEPS versus open perforating vein...

  • EAES recommendations on methodology of innovation management in endoscopic surgery. Neugebauer, Edmund A. M.; Becker, Monika; Buess, Gerhard F.; Cuschieri, Alfred; Dauben, Hans-Peter; Fingerhut, Abe; Fuchs, Karl H.; Habermalz, Brigitte; Lantsberg, Leonid; Morino, Mario; Reiter-Theil, Stella; Soskuty, Gabriela; Wayand, Wolfgang; Welsch, Thilo // Surgical Endoscopy;Jul2010, Vol. 24 Issue 7, p1594 

    Under the mandate of the European Association for Endoscopic Surgery (EAES) a guideline on methodology of innovation management in endoscopic surgery has been developed. The primary focus of this guideline is patient safety, efficacy, and effectiveness. An international expert panel was invited...

  • A second mediastinoscopy: how to decide and how to do it? Van Schil, Paul E.; De Waele, Michèle // European Journal of Cardio-Thoracic Surgery;Apr2008, Vol. 33 Issue 4, p703 

    Summary: Specific indications for a second or remediastinoscopy include an inadequate first procedure, metachronous second primary or recurrent lung cancer, lung cancer after unrelated disease, and restaging after induction therapy. Nowadays, restaging is the most frequent indication for...

  • The presence of CD209 expressing dendritic cells correlates with biofilm positivity in chronic rhinosinusitis with nasal polyposis. Karosi, Tamás; Csomor, Péter; Hegyi, Zoltán; Sziklai, István // European Archives of Oto-Rhino-Laryngology;Sep2013, Vol. 270 Issue 9, p2455 

    Biofilm-positive cases of chronic rhinosinusitis with nasal polyposis (CRSwNP) may form a separate clinical entity, which is characterized by high recurrence rates and resistance against different therapeutic strategies. This can be explained by a special immunologic phenotype. Biofilm existence...

  • Endoscopic management of pancreatic pseudocysts at atypical locations. Bhasin, Deepak Kumar; Rana, Surinder Singh; Nanda, Mohit; Chandail, Vijant Singh; Masoodi, Ibrahim; Kang, Mandeep; Kalra, Navin; Sinha, Saroj Kant; Nagi, Birinder; Singh, Kartar // Surgical Endoscopy;May2010, Vol. 24 Issue 5, p1085 

    There is paucity of data on endoscopic management of pseudocysts at atypical locations. We evaluated the efficacy of endoscopic transpapillary nasopancreatic drain (NPD) placement in the management of pseudocysts of pancreas at atypical locations. Eleven patients with pseudocysts at atypical...

  • Growing Liability Crisis Causes Physician Dissatisfaction.  // hfm (Healthcare Financial Management);Sep2004, Vol. 58 Issue 9, p25 

    Reports on the results of a study published in the July/August 2004 issue of the periodical "Health Affairs," showing that physician dissastisfaction, stemming from the medical liability crisis, may decrease quality of care and strain patient relationships. Survey of specialist physicians in...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics