Successful outcome of flexible ureteroscopy with holmium laser lithotripsy for XXXX 2 cm or greater.

@entity1 @entity1290 @entity295 @entity3816
Although percutaneous nephrolithotomy has been recommended as the first-line treatment for @entity1290 larger than 2 cm, its major complication rate is not negligible and less invasive approaches are to be explored. Thanks to the recent advances in endoscopic technology, flexible ureteroscopy has become another option in this setting. Herein we report our most recent experience with flexible ureteroscopy for large @entity1290 . Between September 2008 and May 2011, 20 @entity1 with @entity1290 >=  2 cm underwent a total of 28 procedures of ureteroscopy with holmium laser lithotripsy, using the Olympus URF-P5 and a ureteral access sheath. The number of procedures, operative time, stone-free rates, stone compositions and complications were evaluated. Stone-free status was defined as the absence of fragments or fragments of  <= 4 mm. Mean stone size was 3.1 cm (range 2.0-5.0). The average number of procedures was 1.4. One, two and three procedures were required in 13, six and one @entity1 , respectively. Overall, the stone-free rate was 90%. The stone-free rate for preoperative stone size of 2 to  <= 4 cm and >4 cm was 100% (14/14) and 67% (4/6), respectively. No major @entity3816 were identified. Postoperative high-grade fever was observed in three @entity1 , including one @entity1 who developed @entity295 . All these @entity1 were successfully treated conservatively. Our findings suggest that ureteroscopy represents a favorable option for selected @entity1 with @entity1290 , especially those 2 to  <= 4 cm in size.
