LAUSR

OBJECTIVE To investigate the effect of the diameter of UAS used during RIRS on operative parameters, perioperative ureteral injury, and ureteral stricture development. MATERIAL AND METHOD The study was designed as a prospective randomized controlled trial and included 320 patients who underwent RIRS. The patients were divided into two groups according to UAS diameter (9.5/11.5 Fr (Group 1) and 12/14 Fr (Group 2)) were used during the operation. At the end of the operation, ureteral injury was checked visually using semi-rigid ureterorenoscopy and classified according to the ureter injury scale. In the postoperative first year, the control CT urography images used to newly developed ureteral dilation. RESULTS There was no statistical difference between the two groups in terms of patient and stone characteristics, operative time, postoperative stone-free rate, and postoperative infection development parameters. In Group 1, 30 (18.8%) of the patients had low-grade and 8 (5%) of the patients had high-grade ureteral injury while in Group 2, 44 (27.5%) had low-grade and 19 (11.9%) had high-grade ureteral injury (p=0.013). In the postoperative period, ureteral stricture was found in 5 (1.6%) patients, of whom 4 (2.5%) were in Group 2 and 1 (0.6%) (p=0.371). CONCLUSION The results of our study showed that the use of a 12/14 Fr UAS in patients who are not previously stented, increases the risk of high grade ureteral injuries, however, despite this increase there is no difference in ureteral stricture formation.