Abstract：Objective:To explore the clinical value of digital flexible ureteroscope with holmium∶YAG laser lithotripsy in the treatment of complex renal calculi.Methods:Retrospective analysis of the outcomes of Olympus e-flexible ureteroscope with holmium∶YAG laser lithotripsy for 51 cases of complicated renal stones in our department. The power ranged from 0.5 J to 1 J, while the frequency of laser ranged from 15 Hz to 30 Hz. The lithotripsy was performed until only very small stone fragments (<2 mm) were observed.Results:In 42 cases (82.4%) sheath was inserted successfully. In all cases, flexible ureteroscopy entered the pelvis successfully, In 39 cases, stone free or residual fragments <4 mm was observed with only one session of treatment. Other 12 cases need second procedure (7 cases were managed with a second flexible ureteroscopic lithotripsy. 5 cases were managed with ESWL). Except for 3 cases of submucosal calcification in renal papilla which residual fragments were larger than 4 mm.Conclusions:Flexible ureteroscope, especially the latest generation of digital flexible ureteroscope, has clear vision and could reached all locations of renal collection systems. When combined with holmium∶YAG laser,flexible ureteroscope is also safe and efficient for treatment of complex renal calculi.
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