Systematic approach in the evaluation of ureteroscopic complications.

Abstract

Introduction. Currently, ureteroscopy has become the method of choice for the treatment of patients with ureter stone location in lower third and middle third. Regardless of the fact that ureteroscopy is an endoscopic, minimally invasive intervention, it is associated with intraoperative complications. Purpose. The main objective of this literature review is to objectify the existing scales of ureter injury, demonstrate evolutionary changes from simple to more detailed, evaluate their advantages and disadvantages, and select the optimal and reproducible tool for assessing postureteroscopic complications. Materials and methods. In this literature review, we used research materials on existing scales of ureter injury published in the databases PubMed, the scientific electronic library of Russia (eLibrary), Scopus, EMBASE, websites of professional associations. Such keywords were used for searching: «postureteroscopic complications», «intraoperative complications of ureteroscopy», «ureteral injuries». This review focuses on the currently existing scales that assess ureteral injury, which can be universal and used in everyday practice. After a detailed check of the reliability of sources, the impact factors of journals and the sequence of presentation of the material, 28 sources were selected directly for citation. Results. According to literature review, historical and present-day knowledge of using postureteroscopic lesion scales in various surgical centers are presented here. Most of scales are focus on disruption of anatomical continuity of the ureter or on complications that develop during the implementation of surgical treatment, which are not specific for this procedure. However, the most detailed description of postureteroscopic complications makes it possible to distinguish between «complicated» and «uncomplicated» ureteroscopy. Conclusion. Thus, PULS scoring system is a standardized and easily reproducible tool in the evaluation of postureteroscopic complications. The emergence of new scales only emphasizes the importance and need for additional prospective and multicenter studies.