Objective: To evaluate the effectiveness and safety of flexible ureteroscopy in the treatment of kidney and upper ureteral calculi under double-J stent free mode.
Methods: Data from patients who underwent flexible ureteroscopy and laser lithotripsy between February 2018 and September 2021 were retrospectively and analysed. Cases were grouped according to pre- or postoperative use of the double-J stent (6 Fr): Post-F group (preoperative double-J stent but no postoperative double-J stent); Pre-F group (no preoperative stenting but with postoperative double-J stent); and Routine group (preoperative and postoperative double-J stenting).
Results: A total of 554 patients (390 male and 164 female) were included. The mean operation time was similar between the three groups, with no statistically significant difference. Incidence of grade 0-1 ureteral injury was significantly higher in the Pre-F group versus other groups, but there were no significant between-group differences in other operation-related complications. During follow-up, stent-associated complications were observed in the Pre-F and Routine groups, but not in the Post-F group. Stone clearance rates were similar between all groups at 1, 3 and 6 months following surgery.
Conclusions: Flexible ureteroscopy using double-J stent free mode was found to be safe, feasible and effective in treating renal and upper ureteral calculi.
Keywords: Flexible ureteroscopy; double-J stent; laser lithotripsy; stent associated complications; stent free; ureteral calculi.