The Clinical Efficacy and Safety of Ureteroscopic Laser Papillotomy to Treat Intraductal Papillary Calculi Associated With Medullary Sponge Kidney.

Objective: To evaluate the safety, efficacy, and durability of ureteroscopic laser papillotomy for the treatment of radiographically visible intraductal papillary calculi and/or free collecting system calculi associated with medullary sponge kidney (MSK).

Methods: The medical records of 25 MSK patients who underwent ureteroscopic laser papillotomy were reviewed at our institution from 2010 to 2013. The follow-up was made in our outpatient department. Pain was assessed using a standard verbal analog pain scale. Patients' pain score, plain abdominal radiograph, ultrasound examination, and urine analysis were routinely performed for each follow-up. We evaluated the procedure-related complications and mean-estimated glomerular filtration rate.

Results: Ureteroscopic laser papillotomy was performed a total of 37 times in 25 patients, including 12 bilateral procedures and 13 unilateral procedures. Significantly less pain was reported after 32 procedures. The mean operative time for unilateral procedure was 38.5 ± 8.2 minutes. The main complications after surgery included urinary infection (2 patients). No serious bleeding was presented in all the patients. The maximum follow-up time was 28.5 months. There was no significant change in the mean-estimated glomerular filtration rate before and after the procedure and at the end of follow-up. Twenty-three patients remained asymptomatic, whereas 2 patients had urinary tract infection (pyelonephritis) during follow-up.

Conclusion: In MSK patients with repeated recurrences of symptomatic stones, ureteroscopic laser papillotomy could be a safe and effective treatment option for radiographically visible intraductal papillary calculi.