Characteristics of patients with fluid extravasation during retrograde ureteroscopic holmium laser lithotripsy for renal calculi.

OBJECTIVES: To explore the risk factors of fluid extravasation during retrograde ureteroscopic holmium laser lithotripsy for renal calculi.

METHODS: Three hundred and twenty-seven patients with renal calculi ranging 10 to 20 mm received retrograde ureteroscopic holmium laser lithotripsy at Renmin Hospital of Wuhan University, Wuhan, China from January 2004 to December 2010. The clinical records were reviewed, and the correlation was studied between various clinical factors and fluid extravasation complications during operation. The clinical factors to be tested included patients' gender and age (<30, 30-50, and >50 years), hydronephrosis degree, previous intervention for renal calculi (none, shock-wave lithotripsy, and open surgery), upper urinary tract infection, ureteral access sheath placement, and procedure duration (<60, 60-120, and >120 mins). The data were processed by SPSS Version 16.0 statistical software, x2 test, and binary logistic regression were used for analysis.

RESULTS: Fluid extravasation complications appeared in 35 patients. Patients’ gender, age, and hydronephrosis degree were irrelevant to the occurrence of fluid extravasation, while having previous open surgery for renal calculi, without ureteral access sheath placement, upper urinary tract infection, and long procedure duration were all responsible for higher incidence of the complications.

CONCLUSIONS: Reasonable selection of patients, effective control of upper urinary tract infection, routine ureteral access sheath placement, and controlling procedure duration help to decrease the incidence of fluid extravasation complications in retrograde ureteroscopic holmium laser lithotripsy for renal calculi.