Laser Ureteroscopy for Calculi in the Upper Urinary Tract: Bicentric Study, Urology Department of Libreville University Hospital, SOS Medecins Clinic

Introduction: Urinary lithiasis represents a significant part of urological practice. Today, it is mainly treated endoscopically. The advent of the flexible ureteroscope (FUS) and laser has further improved the treatment of renal stones. In this paper, we report on our experience in terms of indications and results. Patient and methods: This was a retrospective, descriptive, and analytical study conducted between January 1, 2015, and December 31, 2024, in the urology department of the Libreville University Hospital and a partner private clinic (SOS Medecins). The study included the complete records of patients who underwent semi-rigid or flexible ureteroscopy for upper urinary tract stones with laser fragmentation. The parameters studied were gender, age, reason for consultation, medical history, characteristics of the lithiasis, laterality, indication, duration of the procedure, occurrence of any incidents or accidents, length of hospital stay, and outcome. Success was defined as the absence of lithiasis or the presence of lithiasis fragments less than 3 mm in diameter. Data analysis was performed using SPSS version 20.0 software; means, standard deviations, frequencies, and extremes were calculated. Results:88 laser ureteroscopies were performed on 82 patients. There were 55 men and 33 women, giving a sex ratio of 1.7. The average age was 42.97 years (range 21 to 77 years). The main reason for consultation was renal colic in 70 patients (79.54%), followed by chronic low back pain in 12 patients (13.64%). The stones were unilateral in 75 patients (91.5%) and bilateral in 7 (8.5%). The locations were mainly pyelic and middle calyceal (19.3% each). The average size of the stones was 8 mm (ranging from 3 to 35 mm). The overall success rate was 93.9%. Postoperatively, complications were minor according to the Clavien-Dindo classification and occurred in 6.1% of cases. The average length of hospital stay was 3 days. Conclusion: The treatment of upper urinary tract lithiasis by laser ureteroscopy has been effective in Libreville for 10 years, despite its high cost, which limits its use. Its practice is becoming commonplace in view of the advantages it offers compared to conventional surgery.