Risk Factors, Complications, and Outcomes in Flexible Ureteroscopy: A Retrospective Study from Riyadh, Saudi Arabia (2022–2024)

Objective: This study evaluates the risk factors, complications, and outcomes associated with flexible ureteroscopy (FURS) for the treatment of renal and proximal ureteral stones at Imam Abdulrahman Al-Faisal Hospital, Riyadh, Saudi Arabia. Methods: A retrospective analysis was conducted on 175 patients who underwent FURS between June 2022 and January 2024. Data collected included demographics, comorbidities, operative details, and postoperative complications. Statistical analyses were performed to identify associations between patient characteristics and complications, with significance set at p < 0.05. Results: The cohort had a mean age of 41.31 years, with 81.14% male patients. Common comorbidities included diabetes mellitus (21.71%) and hypertension (17.71%). The most frequent complications were residual stones (5.14%), hematuria (5.71%), and ureteral injuries (6.29%). Diabetes was significantly associated with infections (p < 0.001) and urosepsis (p = 0.001), while hypertension was linked to infections (p < 0.05). No significant associations were found between operative duration and complications. Overall, 97.14% of patients achieved clinical improvement, with a 0.57% mortality rate due to urosepsis. Conclusion: FURS is a safe and effective procedure with a high success rate and manageable complications. Diabetes and hypertension are significant risk factors for postoperative infections, underscoring the need for preoperative risk assessment and targeted interventions. Future studies should validate these findings across multicenter settings and explore advancements in technology to further improve patient outcomes.