[30] Outcomes of emergency vs elective ureteroscopy for a single ureteric stone

Objective To compare the results of emergency vs elective ureteroscopy (URS) for the treatment of a single ureteric stone. Methods We prospectively constructed a database for patients who underwent URS in the Al-Amiri Hospital from March 2015 through December 2017. Inclusion criteria were adult patients with a single ureteric stone diagnosed by computed tomography of the kidneys, ureters and bladder. Patients who had fever or ureteric stents were excluded. The emergency URS group (EM Group) included patients who presented to the emergency department with persistent renal colic and underwent emergency URS. The elective URS group (EL Group) included patients who underwent elective URS after admission through the outpatient appointment system. The technique for URS was the same in both groups. Safety was defined as absence of complications, whilst effectiveness was defined as stone-free rate after a single URS session. The chi-squared and t -test were used to compare the data of both groups. Results The study included 124 patients with a mean (SD) age of 41.4 (12.6) years. The EM Group included 67 patients and the EL Group included 57 patients. Laser disintegration was needed in 48 patients (84%) in the EL Group and 43 (64%) in the EM Group ( P = 0.012). Post-URS stents were placed in 43 patients (75.4%) in the EL Group and 60 (89.6) in the EM Group ( P = 0.037). Complications were comparable (3.5% for the EL and 4.5% for EM groups, P = 0.785). Ureteric perforation in one patient in the EM Group was treated with a JJ stent. Sepsis in one patient in each group was treated with culture-sensitive antibiotics. Upper tract obstruction after removal of the ureteric catheter in one patient in the EL Group required a JJ stent. Haematuria in one patient in EM Group was treated with blood transfusion. Stone-free rates were comparable, 93% in the EL Group and 97% in the EM Group ( P = 0.297). Conclusion Emergency URS in selected cases can be as safe and effective as elective URS for treatment of a single ureteric stone.