Effectiveness of Curved Guidewire in the Treatment of Ureteroscopic Access Difficulty for Patients with Ureterovesical Junction Stones
Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v6i4.4625
Abstract
Objective: This paper aims to investigate the safety and efficacy of using a curved guidewire for the treatment of ureterovesical junction stones when ureteroscopic access is difficult. Methods: The clinical data of 34 patients with ureterovesical junction stones admitted to our department in the past 3 years were analyzed retrospectively. The patients were divided into two groups according to the guidewire used during surgery: the treatment group (17 cases) consisted of patients who underwent successful surgery with a curved guidewire after encountering difficulty in ureteroscopic access; the control group (17 cases) included patients who successfully completed ureteroscopic lithotripsy using a Black Mamba guidewire (COOK, HWS-035150). The operation time, hospital stay, incidence of postoperative hematuria, double J stent removal time, and recovery of ureteral dilatation and hydronephrosis were compared between the two groups. Results: All patients in both groups successfully completed the surgery, and double J stents were indwelled postoperatively, which were removed smoothly at 4 weeks after surgery. Univariate analysis showed that the operation time of the treatment group [(45.50±14.25) min] was significantly longer than that of the control group [(35.30±10.50) min], with a statistically significant difference (P<0.05). However, there were no statistically significant differences between the two groups in terms of hospital stay, incidence of postoperative hematuria, double J stent removal time, and recovery of ureteral dilatation and hydronephrosis (all P>0.05). Conclusion: For patients with ureterovesical junction stones who experience difficulty in ureteroscopic access, switching to a curved guidewire can effectively complete the surgery. The postoperative recovery indicators of this approach are not significantly different from those of conventional surgery using a Black Mamba guidewire, indicating good clinical practicality.
Keywords
ureteroscope; ureterovesical junction stones; curved guidewire; black mamba guidewire; clinical practicality
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[5] Yang X., Analysis of Factors Affecting Complications in 200 Ureteroscopic Surgeries, Modern Diagnosis and Therapy 27(17) (2016) 3261-3262.
[6] He Y., Ma S., Liu X., He D., Clinical Analysis of 30 Misdiagnosed Cases of Ureterovesical Junction Stones, Clinical Misdiagnosis & Mistreatment 20(3) (2007) 30-31.
[7] Zhong W., Wei H., Li X., Comparison of Efficacy and Cost Between Ureteroscopy and Extracorporeal Shockwave Lithotripsy for Distal Ureteral Stones, Chinese Journal of Endoscopy 6(3) (2000) 31-32.
[8] O. Wiseman, D. Smith, K. Starr, L. Aucott, R. Hernández, R. Thomas, S. MacLennan, C.T. Clark, G. MacLennan, D. McRae, V. Bell, S. Cotton, Z. Gall, B. Turney, S. McClinton, The PUrE Randomised Controlled Trial 1: Clinical and Cost Effectiveness of Flexible Ureterorenoscopy and Extracorporeal Shockwave Lithotripsy for Lower Pole Stones of ≤10 mm, European Urology 88 (2025) 179-189.
[9] Yu H., Zuo Z., Qian J., Experience of Ureteroscopic Pneumatic Lithotripsy for Ureterovesical Junction Stones, Modern Medicine 41(11) (2013) 858-860.
[10] Zuo C., Zhang L., Deng L., et al., Effects of Combined Flexible Ureteroscopy and Percutaneous Nephrolithotomy on Stone Clearance and Prognosis in Complex Renal Calculi, Chinese and Foreign Medical Research 17(1) (2019) 22-24.
[11] C. Radmayr, C. Schwentner, A. Lunacek, A. Karatzas, J. Oswald, Embryology and Anatomy of the Vesicoureteric Junction with Special Reference to the Etiology of Vesicoureteral Reflux, Ther Adv Urol 1 (2009) 243-250.
[12] P. Geavlete, D. Georgescu, G. Niţă, V. Mirciulescu, V. Cauni, Complications of 2735 Retrograde Semirigid Ureteroscopy Procedures: A Single-Center Experience, J Endourol 20 (2006) 179-185.
[13] H. Tran, O. Arsovska, R.F. Paterson, B.H. Chew, Evaluation of Risk Factors and Treatment Options in Patients with Ureteral Stricture Disease at a Single Institution, Can Urol Assoc J 9 (2015) E921-924.
[14] Li Q., Mei J., Wang T., Luo F., Jie M., Causes and Countermeasures of Difficult Ureteroscopic Insertion, Jilin Medical Journal 33(15) (2012) 3142-3143.
[15] Zhao Y., Zhang L., Zhang C., Zhang Z., Guo F., Wang B., Xiang W., Wu P., Hu W., Clinical Analysis of Endoscopic Treatment of Ureteral Stricture, Chinese Journal of Minimally Invasive Surgery (2012) 49-51.
[16] Zhao L., Yang C., Wang J., Causes and Management of Difficult Ureteroscopic Insertion, Chinese Journal of Modern Surgery 15 (2011).
[17] R.M. Scarpa, A. De Lisa, D. Porru, E. Usai, Large Benign Prostatic Hyperplasia Means Impossible Ureteroscopy: Myth or Reality?, European Urology 37 (2000) 381-385.
[18] Wang R., Chen L., Wang X., Observation on the Efficacy of Ureteroscopy in Treating Ureterovesical Junction Stones, Chinese Journal of Laparoscopic Urology 6(3) (2012) 214-216.
[19] Yang Y., Clinical Effects of Holmium Laser Lithotripsy and Pneumatic Lithotripsy for Ureteral Stones, Medical Equipment 33(11) (2020) 129-130.
[20] Sun X., Lin W., Wu W., Tan J., Comparison of Holmium Laser and Pneumatic Lithotripsy for Ureteral Stones Under Ureteroscopy, Chinese Journal of Minimally Invasive Surgery (2009) 29-31.
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