The effect of isothermic irrigation fluid on ureteroscopic lithotripsy outcomes.

Introduction: Ureteroscopic lithotripsy is amongst the most performed surgeries in urology practice. To achieve better results and lower complications, several approaches have been proposed. Using isothermic irrigation fluid in ureteroscopy is a novel method.The aim of this study was to show the advantages of body temperature irrigation fluid in ureteroscopy compared to room temperature fluid.

Material and methods: A total of 94 patients with a single ureteral stone scheduled for semirigid ureteroscopy were enrolled into this study. Patients were randomised into 2 groups: group 1, ureteroscopy with room temperature (20-22°C) irrigation fluid and group 2, ureteroscopy with body temperature (37°C) irrigation fluid. Patient characteristics, stone characteristics (stone side, stone location, stone burden, Hounsfield unit), operation outcomes (operation time, ureteral JJ stenting, complications, stone free rate after 4 weeks, auxiliary intervention, Visual Analogue Scale) were analysed.

Results: There was no statistically significant difference between two groups regarding patient and stone characteristics. Operation time was found to be shorter in group 2 compared to group 1 (p = 0.02). Post-operative pain was also less common in group 2 compared to group 1 (p <0.001). Complication rates were 17% in group 1 and 8% in group 2 but no statistically significant difference was found.

Conclusions: Isothermic irrigation fluid in ureteroscopy is beneficial because: it facilitates easier ureteral access by decreasing ureteral spasms, shortens operation times, lowers post-operative pain and lowers the complications rates. This method can be used in semirigid ureteroscopy because it is an easily applicable method with no known associated complications.