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Peer-reviewedCC BYBJUI compass

Ambulatory bilateral same-session vs. unilateral ureteroscopy: A multicentre cohort study.

  • Mohamed Abdelkareem1,2
  • Tawiz Gul1,2
  • Mohannad Natheef AbuHaweeleh2
  • Humam Emad Rajha2
  • Hamzah Shehadeh3
  • Mohammed Ebrahim1
  • Ibrahim Alnadhari4,2
  • Osama Abdeljaleel4
  • Abdullah Al-Ansari3,2
  • Khaled Al-Rumaihi3,2
  • Khalid Al Jalham3,2
  • Asad Zeidan2
1 more authors
  • Morshed Salah1,2
4 affiliations
  1. 1Urology Section, Surgery Department, Hazm Mebaireek General Hospital Hamad Medical Corporation Doha Qatar.
  2. 2College of Medicine, QU Health Qatar University Doha Qatar.
  3. 3Urology Section, Surgery Department, Ambulatory Care Center Hamad Medical Corporation Doha Qatar.
  4. 4Urology Section, Surgery Department, Al Wakra Hospital Hamad Medical Corporation Al Wakra Qatar.
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Abstract

Objective

To evaluate the safety, efficacy and feasibility of ambulatory bilateral same-session retrograde intrarenal surgery (BSS-RIRS) compared to unilateral RIRS, under a standardized clinical protocol.Patients and methods

We conducted a retrospective multicentre cohort study including 202 adult patients who underwent ambulatory bilateral same-session RIRS (BSS-RIRS) or unilateral RIRS between January 1 and December 31, 2024. All included patients had complete perioperative data and postoperative non-contrast CT imaging at 4-6 weeks. Of these, 95 underwent BSS-RIRS and 107 underwent unilateral RIRS. Demographic, clinical and operative variables were analysed. Stone-free status (defined as residual fragments ≤4 mm) and complication rates (within 30 days) were assessed. Multivariable logistic regression was used to adjust for potential confounders.Results

BSS-RIRS patients had significantly longer operative times compared to the unilateral group (106.9 vs. 87.3 minutes, p < 0.001) and were more likely to be treated with thulium lasers (73.4% vs. 54.2%, p = 0.003). Preoperative stenting was notably less common in the BSS-RIRS group (39% vs. 65.4%, p < 0.001). Despite these differences, early complication rates remained low and statistically similar between groups (2.1% vs. 3.7%, p = 0.49), with adjusted regression analysis showing a possible non-inferior BSS-RIRS early complication rate (OR 0.36, p = 0.209). Overall stone-free rates were comparable (85.3% vs. 82.3%, p = 0.56). In regression analysis, bilateral RIRS showed increased odds of stone-free status, but this was not statistically supported (adjusted OR 1.62, 95% CI 0.64-4.10, p = 0.309). Grade A stone-free status (0 mm residual) was significantly lower in the bilateral group (72.8% vs. 93.2%, p < 0.001).Conclusion

Ambulatory BSS-RIRS is a safe and effective approach for managing bilateral renal stones, offering comparable overall stone-free rates and complication profiles to unilateral RIRS. Additionally, it provides procedural efficiency and potential cost-effectiveness when applied in appropriately selected cases. Further studies are warranted to refine patient selection criteria and validate long-term outcomes.

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Cite

BibTeXRIS
BibTeX
@article{abdelkareem2026ambulatory,
  title = {{Ambulatory bilateral same-session vs. unilateral ureteroscopy: A multicentre cohort study.}},
  author = {Mohamed Abdelkareem and Tawiz Gul and Mohannad Natheef AbuHaweeleh and Humam Emad Rajha and Hamzah Shehadeh and Mohammed Ebrahim and Ibrahim Alnadhari and Osama Abdeljaleel and Abdullah Al-Ansari and Khaled Al-Rumaihi and Khalid Al Jalham and Asad Zeidan and Morshed Salah},
  journal = {BJUI compass},
  year = {2026},
  month = oct,
  doi = {10.1002/bco2.70109},
  url = {https://europepmc.org/article/MED/42903597},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Ambulatory bilateral same-session vs. unilateral ureteroscopy: A multicentre cohort study.
AU  - Mohamed Abdelkareem
AU  - Tawiz Gul
AU  - Mohannad Natheef AbuHaweeleh
AU  - Humam Emad Rajha
AU  - Hamzah Shehadeh
AU  - Mohammed Ebrahim
AU  - Ibrahim Alnadhari
AU  - Osama Abdeljaleel
AU  - Abdullah Al-Ansari
AU  - Khaled Al-Rumaihi
AU  - Khalid Al Jalham
AU  - Asad Zeidan
AU  - Morshed Salah
PY  - 2026
DA  - 2026/10/20
JO  - BJUI compass
DO  - 10.1002/bco2.70109
UR  - https://europepmc.org/article/MED/42903597
AB  - Objective  To evaluate the safety, efficacy and feasibility of ambulatory bilateral same-session retrograde intrarenal surgery (BSS-RIRS) compared to unilateral RIRS, under a standardized clinical protocol.Patients and methods  We conducted a retrospective multicentre cohort study including 202 adult patients who underwent ambulatory bilateral same-session RIRS (BSS-RIRS) or unilateral RIRS between January 1 and December 31, 2024. All included patients had complete perioperative data and postoperative non-contrast CT imaging at 4-6 weeks. Of these, 95 underwent BSS-RIRS and 107 underwent unilateral RIRS. Demographic, clinical and operative variables were analysed. Stone-free status (defined as residual fragments ≤4 mm) and complication rates (within 30 days) were assessed. Multivariable logistic regression was used to adjust for potential confounders.Results  BSS-RIRS patients had significantly longer operative times compared to the unilateral group (106.9 vs. 87.3 minutes, p < 0.001) and were more likely to be treated with thulium lasers (73.4% vs. 54.2%, p = 0.003). Preoperative stenting was notably less common in the BSS-RIRS group (39% vs. 65.4%, p < 0.001). Despite these differences, early complication rates remained low and statistically similar between groups (2.1% vs. 3.7%, p = 0.49), with adjusted regression analysis showing a possible non-inferior BSS-RIRS early complication rate (OR 0.36, p = 0.209). Overall stone-free rates were comparable (85.3% vs. 82.3%, p = 0.56). In regression analysis, bilateral RIRS showed increased odds of stone-free status, but this was not statistically supported (adjusted OR 1.62, 95% CI 0.64-4.10, p = 0.309). Grade A stone-free status (0 mm residual) was significantly lower in the bilateral group (72.8% vs. 93.2%, p < 0.001).Conclusion  Ambulatory BSS-RIRS is a safe and effective approach for managing bilateral renal stones, offering comparable overall stone-free rates and complication profiles to unilateral RIRS. Additionally, it provides procedural efficiency and potential cost-effectiveness when applied in appropriately selected cases. Further studies are warranted to refine patient selection criteria and validate long-term outcomes.
SN  - 2688-4526
ER  -