An update on ureteroscopic instrumentation for the treatment of urolithiasis

PURPOSE OF REVIEW: Ureteroscopic instruments, both endoscopic and working devices, continue to evolve. Changes in instrumentation have necessitated concurrent modifications in ureteroscopic techniques over the years. The safety and efficacy of the ureteroscopic approach for the treatment of renal and ureteral calculi, however, have continued to improve. RECENT FINDINGS: This review emphasizes the recent advances in the major groups of instruments employed for ureteroscopy. Among the endoscopic instruments, the flexible ureteroscopes have undergone the most notable advances, benefiting from greatly improved deflection and durability. Progress has been made in adjunctive instruments as well. Current stone retrieval devices composed of nitinol-based wire technology are able to easily secure fragments from the most peripheral calices. The holmium laser is a versatile device with proven safety and effectiveness as an endoscopic lithotrite. SUMMARY: The availability and coordinated use of the latest ureteroscopic instruments have resulted in better treatment outcomes, thus expanding the use of ureteroscopy as a first-line option for the treatment of calculi in appropriate cases. Urologists should be familiar with currently available instrumentation in order to optimize their equipment.