Publication Details
Abstract
Ureteroscopy (URS) is increasingly utilized in the management of urinary stone disease across a spectrum of non-standard clinical scenarios. This review synthesizes evidence on URS application in challenging situations including bilateral urolithiasis, single kidney stones, obesity, renal transplant recipients, pregnant women, and pediatric patients. Drawing from a comprehensive literature review, this article evaluates outcomes, complications, and adherence to current guidelines from the European Association of Urology (EAU) and the American Urological Association (AUA). Notably, bilateral URS, although associated with lower stone-free rates and higher reoperation rates compared to unilateral procedures, demonstrates safety and efficacy. URS in single kidney patients exhibits favorable stone-free rates with manageable complications. In obese individuals, URS proves comparable to outcomes in the general population. URS emerges as a viable option for urolithiasis in renal transplant recipients, pregnant women, and children, offering high stone-free rates and acceptable morbidity. The review underscores the importance of obstetric support in pregnant patients and emphasizes the acceptability of URS and extracorporeal shock wave lithotripsy (ESWL) as first-line therapies for pediatric stones. Despite advancements in URS technology facilitating its use in diverse clinical scenarios, further randomized controlled trials are warranted to validate its efficacy across these populations.