Poster session 5: Nephrolithiasis| Volume 8, ISSUE 8, P680-681, September 2009

C67 Ureteroscopic instrument damage; experience after 5,500 ureteroscopies

      Introduction and Objectives

      Damage of the endoscopes or accessory instruments during ureteroscopy as well as other endourological interventions represents an intraoperative incident sometimes imposing the termination of the procedure or supplementary maneuvers for endoscopic removal. Our study aimed to review such incidents after a significant experience.

      Material and Methods

      Between June 1994 and February 2009, 5102 patients underwent retrograde ureteroscopy (5534 ureteroscopic procedures). Retrograde flexible ureteroscopy was performed in 173 cases, while 5361 procedures were performed using the semirigid ureteroscope. The instrumental damage encountered during all these procedures was reviewed.


      Severe damages to the endoscopes requiring their replacement was encountered in 6 cases (0.1%): deterioration of the optical system (1 case) and complete breakage (1 case) of the semirigid 10F ureteroscopes, respectively deterioration of the outer sheath (1 case), perforation of the working channel (1 case) and breakage of the majority of fibers composing the optical system (2 cases) of the flexible ureteroscopes. Damage of the accessory instruments occurred in other 18 cases (0.3%): basket fracture (5 cases, 1 for impacted calculus release), grasping extractors’ breakage (4 cases), balloon dilator tearing (1 case), guidewire fracture (4 cases) and lithotripsy probes breakage (4 cases). 10 of these cases necessitated active removal maneuvers of the foreign bodies (parts of accessory instruments).


      Instrumental damage during ureteroscopic procedures is not a very frequent intraoperative incident in a center with high experience in this field. However, analysis of these cases is crucial in order to avoid future similar accidents.