Experience and outcome of simultaneous bilateral endoscopic surgery (SBES) for patients with bilateral upper tract urolithiasis

Abstract

Introduction: 15% of Urolithiasis patients presents with bilateral renal stones. Management of patients with renal stones along with ureteric stones commonly requires staged approach. Simultaneous bilateral endoscopic surgery (SBES) has emerged as more efficient treatment option which allows management of renal and ureteric stone in a simultaneous manner. We report our experience with SBES for patients with bilateral Urolithiasis. Patients and Methods: From May 2018 to February 2020, 12 patients who would otherwise have been treated in staged or in consecutive manner were planned for Simultaneous Bilateral Endoscopic surgery. Procedures were performed in the FOSML position to achieve both antegrade and retrograde access. Management of renal stones by supine approach and retrograde uretroscopic lithotripsy for ureteric stones under general anesthesia. Results: A total of 12 patients underwent simultaneous bilateral endoscopic surgery. Among these 12 patients, 2 patients had contra lateral upper ureteric calculus, 4 had mid ureteric calculus and remaining 6 had lower ureteric calculus. 11 patients were discharged on second postoperative day and remaining 1 patient was discharged on 3rd postoperative day due to procedure related complication. Conclusion: Simultaneous bilateral endoscopic surgery can be performed in FOSML position and is safe and effective procedure with shorter operative time and anesthesia. Procedure is beneficial for patient, healthcare system and surgeon.