Objective: To evaluate the efficacy, safety, and impact on renal function of same-session bilateral ureteroscopy and laser lithotripsy in patients diagnosed with simultaneous bilateral ureteral stones.
Materials and Methods: The data of 80 primary patients who underwent bilateral ureteroscopy for simultaneous bilateral ureteral stones between December 2015 and December 2025 were retrospectively reviewed. Thin-tipped semirigid ureteroscope and a Holmium:YAG laser (1J/10Hz) were used in all procedures. Surgical success (stone-free) was defined as complete clearance or the presence of fragments <4 mm on imaging performed at the 4th postoperative week.
Results: The mean age of the 80 patients included in the study was 43.6 ± 15.4 years, the mean total stone burden was 19.9 ± 5.3 mm, and the median operative time was 60.0 (IQR: 48.75–75.0)minutes. The median hospital stay was 2.0 (IQR: 2.0–4.0) days. The stone-free rate (SFR) after the first session was 88.75%, while the final SFR reached 96.25% after additional interventions. Serum creatinine levels showed a significant decrease from a preoperative median of 1.16 mg/dL to a postoperative level of 0.9 mg/dL (p < 0.001). The overall complication rate was 12.5% (n = 10), all of which were Clavien-Dindo Grade I-II (minor). No major complications such as ureteral perforation or avulsion were observed in our series.
Conclusion: Same-session bilateral ureteroscopy is a safe and effective method for the treatment of simultaneous bilateral ureteral stones, offering high success rates, a low morbidity profile, and rapid improvement in renal function. With appropriate patient selection, bilateral ureteroscopy should be considered a standard approach in bilateral stone disease.
Keywords: bilateral ureteral stone, bilateral ureteroscopy, laser lithotripsy, stone-free rate, complication
Abstract
Objective: To evaluate the efficacy, safety, and impact on renal function of same-session bilateral ureteroscopy and laser lithotripsy in patients diagnosed with simultaneous bilateral ureteral stones.
Materials and Methods: The data of 80 primary patients who underwent bilateral ureteroscopy for simultaneous bilateral ureteral stones between December 2015 and December 2025 were retrospectively reviewed. Thin-tipped semirigid ureteroscope and a Holmium:YAG laser (1J/10Hz) were used in all procedures. Surgical success (stone-free) was defined as complete clearance or the presence of fragments <4 mm on imaging performed at the 4th postoperative week.
Results: The mean age of the 80 patients included in the study was 43.6 ± 15.4 years, the mean total stone burden was 19.9 ± 5.3 mm, and the median operative time was 60.0 (IQR: 48.75–75.0)minutes. The median hospital stay was 2.0 (IQR: 2.0–4.0) days. The stone-free rate (SFR) after the first session was 88.75%, while the final SFR reached 96.25% after additional interventions. Serum creatinine levels showed a significant decrease from a preoperative median of 1.16 mg/dL to a postoperative level of 0.9 mg/dL (p < 0.001). The overall complication rate was 12.5% (n = 10), all of which were Clavien-Dindo Grade I-II (minor). No major complications such as ureteral perforation or avulsion were observed in our series.
Conclusion: Same-session bilateral ureteroscopy is a safe and effective method for the treatment of simultaneous bilateral ureteral stones, offering high success rates, a low morbidity profile, and rapid improvement in renal function. With appropriate patient selection, bilateral ureteroscopy should be considered a standard approach in bilateral stone disease.
Keywords: bilateral ureteral stone, bilateral ureteroscopy, laser lithotripsy, stone-free rate, complication