Combined laparoscopic pyeloplasty and suctioning ureteral access sheath assisted flexible ureteroscopy in the treatment of ureteropelvic junction obstruction coexisting with renal calculi: A multi-center retrospective observational study

Abstract

Abstract Background Ureteropelvic junction obstruction (UPJO) is a common obstructive disease of the urinary tract. It is very common for UPJO patients to have coexistent renal calculi. The main aim of therapy is the relief of the obstruction and the removal of the stones at the same time. Methods This retrospective study included 110 patients diagnosed with the UPJO coexisting with multiple renal calculi at the Shanxi Bethune Hospital and the First Hospital of Shanxi Medical University between March 2016 and January 2022. Patients were divided according to the different methods of dealing with UPJO and renal calculi. In group A, patients received traditional open pyeloplasty and pyelolithotomy. In group B, patients received percutaneous nephrolithotomy first and then received laparoscopic pyeloplasty. In group C, patients received flexible cystoscopy to extract stones and then laparoscopic pyeloplasty. In group D, patients received vacuum suction access sheath-assisted flexible ureteroscopy and underwent laparoscopic pyeloplasty. The stones were smashed using a holmium laser. The success rate of pyeloplasty, stone clearance rate, operation time, bleeding amount, complication occurrence rate, post-surgical pain, length of stay, and hospitalization cost were compared between groups. The follow-up period was at least 2 years. Results By using flexible ureteroscopy and a vacuum suction urethral access sheath, the renal stone clearance rate was significantly increased, and the complication occurrence rate and the operation time were significantly reduced in the UPJO patients coexisting with multiple renal calculi. Conclusions Laparoscopic pyeloplasty combined with flexible ureteroscopy and a vacuum suction urethral access sheath is safe and effective in dealing with UPJO in patients complicated by renal caliceal stones. Trial registration Retrospectively registered