Flexible ureteroscopy in upper urinary tract disease (report of 29 cases)

[Objective]To explore diagnostic or therapeutic applications of flexible ureteroscopy for the manargement of upper urinary tract disease.[Methods]A series of 29 patients undergoing retrograde or antegrade flexible ureteroscopy for upper urinary tract disease. 12 cases of renal staghorn calculi were selected to be treated by single channel percutaneous nephrostolithotomy (PCNL) combined with flexible ureteroscopy lithotripsy using holmium laser. Flexible ureteroscopy was performed for diagnosis of 10 cases of pyelocalices lesions and treatment of 7 cases of ureteral stricture and ureteral calculi after urinary diversion. [Results]The overall stone-free rate was 83.3% (10/12), two patients (16.7%) had a residual 7 mm calculi. Successfully diagnostic flexible ureteroscopy identified pyelocalices lesions and hematuria in 9 cases (90%): tumours (7 cases), blood clot (2 cases) and one patients failed to access the lesion location. 6 cases (85.7%) of obstructive disease of urinary diversion were successfully treated by flexible ureteroscopy: calculi (3 cases), anastomotic strictures (2 cases), calculi combined with stricture (1 case), and 1 case of calculus failed to access. Severe complication weren’t observed in all cases. [Conclusions] Flexible ureteroscopy is an effective, reproducible and minimally traumatic diagnostic and therapeutic technique for upper urinary tract disease. Flexible ureteroscopy is especially potential in the treatment of renal staghorn calculi, obstructive diseases after urinary diversion and the diagnosis of pyelocalices lesions.