Complications of Semirigid Ureteroscopy in Ureteric Stone Treatment

Introduction Ureteroscopy (URS) is a minimally invasive endoscopic technique commonly used to manage ureteric stones. This study prospectively reports and grades the complications associated with semirigid URS for ureteric stone removal and aims to identify factors contributing to these complications. Methods Prospective data were collected from 160 consecutive patients who underwent semirigid URS for ureteric stones at a single center between June 2021 and December 2022. Intraoperative complications were classified using Satava's system, while postoperative complications were categorized according to the Modified Clavien-Dindo classification. Results The overall complication rate was 19.4%. Intraoperative complications occurred in 9.4% of cases, postoperative complications in 10.6%, and 0.6% experienced both. The most frequent intraoperative complication was failure to reach the stone (3.8%), while postoperative fever was the most common postoperative complication (4.4%). Larger stone size (p = 0.03), proximal stone location (p < 0.001), and presence of comorbidities (p = 0.012) were significantly associated with higher complication rates. Conclusions Semirigid URS is generally a safe and effective treatment for ureteric stones, especially in patients with favorable stone characteristics and comorbidity profiles. However, caution is advised when managing larger or proximally located stones and in patients with multiple comorbidities, as these factors increase the risk of complications. Future research should focus on multicenter studies with larger cohorts and longer follow-up periods to better understand late complications such as ureteric strictures. Additionally, investigating the impact of surgeon experience and patient demographics on complication rates could help optimize case selection and management strategies in URS.