• Muhamad Abu Ahmed, Waslem Abu Nasra, Ali Safadi, Alexander Visoky, Ibrahim Elias, and Ran Katz.
• Department of Urology, Ziv Medical Center, affiliated with Azrieli Faculty of Medicine in the Galilee, Safed, Israel.
• Isr Med Assoc J. 2022 Jan 1; 24 (1): 47-51.

BackgroundUreteroscopy is becoming the primary treatment for ureteral stones. As a standard of care, ureteroscopy is performed under the supervision of fluoroscopy. Recent advances in endourological technology make the need for fluoroscopy questionable.ObjectivesTo summarize our experience with a no-fluoroscopy technique for selected cases of ureteral stones.MethodsPatients were considered suitable for fluoroless ureteroscopy if they had one or two non-impacted stones, in any location in the ureter, 5-10 mm size, with a normal contralateral renal unit and no urinary tract infection. Procedures were performed using rigid scopes, nitinol baskets/forceps for stone retrieval, and Holmium:YAG laser for lithotripsy. Stents were placed per surgeon's decision.ResultsDuring an 18-month period, 103 patients underwent fluoroless ureteroscopy. In 94 patients stones were removed successfully. In six, the stones were pushed to the kidney and treated successfully on a separate session by shock wave lithotripsy. In three patients no stone was found in the ureter. In five patients, miniature perforations in the ureter were noted and an indwelling double J stent was placed.ConclusionsFluoroless ureteroscopy resulted in a high rate of success. We believe that in selected cases it can be used with minimal adverse events.

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