Relocation, laser dusting and suction (RELOADUS): An international collaborative observational study for laser management to prevent strictures of symptomatic impacted upper ureteric stones
5 affiliations
- 1School of Medicine, University of Dundee, Scotland, UK
- 2Department of Urology, Max Super Speciality Hospital, Shalimar Bagh, New Delhi, India
- 3Department of Urology, Tawam Hospital, Al Ain, United Arab Emirates
- 4Department of Urology, Sulaiman Al-Habib Medical Group, Arryan Hospital, Riyadh, Kingdom of Saudi Arabia
- 5Department of Urology, College of Medicine, Al Faisal University, Riyadh, Kingdom of Saudi Arabia
Abstract
Background: Ureteric stricture formation following ureteroscopy and laser management of stones is known.
Objective: To evaluate the feasibility, safety, stone clearance outcomes and rate of upper ureteric stricture formation after implementation of the Relocation, laser dusting and suction (RELOADUS) technique for the endoscopic management of impacted upper ureteric stones.
Methods: This is an international collaborative study recruiting 80 consecutive patients with impacted upper ureteric stones with a mean size of 7.2 mm ± 4.2. Patients were managed by relocation of impacted upper ureter stones, laser dusting and suction at multiple centres (intervention group). A control group (n = 80) was identified from the databases of these centres to assess the outcome. Primary outcome of the study was the rate of ureteric stricture formation on follow-up.
Key Findings and Limitations: At a mean follow-up of 12.2 ± 5.9 months, the observed rate of upper ureteric stricture was lower in the intervention group than in the control group, although this difference did not reach statistical significance (1/80, 1.25% vs. 4/80, 5%; p = 0.367). Similarly, a higher rate of residual stone fragments was seen on follow-up imaging at 3 months in the control group (p = 0.002). There were no differences in the duration of procedure or follow-up unscheduled admissions between the groups.
Intervention: RELOADUS is a technique where impacted upper ureteric stones are relocated into renal pelvis, dusted using laser and then suction applied to achieve complete clearance.
Conclusions: The RELOADUS technique appears to be a feasible and safe management strategy for impacted upper ureteric stones. By relocating impacted stones from the narrow ureter to the more capacious renal pelvis and utilising laser dusting with suction, the approach achieved high stone-free rates while aiming to reduce laser activation and instrumentation within the ureter. Larger prospective studies are required to confirm its effect on ureteric stricture formation.
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BibTeX
@article{shah2026relocation,
title = {{Relocation, laser dusting and suction (RELOADUS): An international collaborative observational study for laser management to prevent strictures of symptomatic impacted upper ureteric stones}},
author = {Syed Mustafa Shah and Zaara Nabi and Nipun Bansal and Waheed uz Zaman and Mohammed Hidayat Khan and Zubda Malik and Taher Marry and Jose Antonio Sanudo Campos and Ghulam Nabi},
journal = {Scottish Medical Journal},
year = {2026},
month = oct,
doi = {10.1177/00369330261480995},
url = {https://doi.org/10.1177/00369330261480995},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Relocation, laser dusting and suction (RELOADUS): An international collaborative observational study for laser management to prevent strictures of symptomatic impacted upper ureteric stones
AU - Syed Mustafa Shah
AU - Zaara Nabi
AU - Nipun Bansal
AU - Waheed uz Zaman
AU - Mohammed Hidayat Khan
AU - Zubda Malik
AU - Taher Marry
AU - Jose Antonio Sanudo Campos
AU - Ghulam Nabi
PY - 2026
DA - 2026/10/16
JO - Scottish Medical Journal
DO - 10.1177/00369330261480995
UR - https://doi.org/10.1177/00369330261480995
AB - Background: Ureteric stricture formation following ureteroscopy and laser management of stones is known. Objective: To evaluate the feasibility, safety, stone clearance outcomes and rate of upper ureteric stricture formation after implementation of the Relocation, laser dusting and suction (RELOADUS) technique for the endoscopic management of impacted upper ureteric stones. Methods: This is an international collaborative study recruiting 80 consecutive patients with impacted upper ureteric stones with a mean size of 7.2 mm ± 4.2. Patients were managed by relocation of impacted upper ureter stones, laser dusting and suction at multiple centres (intervention group). A control group (n = 80) was identified from the databases of these centres to assess the outcome. Primary outcome of the study was the rate of ureteric stricture formation on follow-up. Key Findings and Limitations: At a mean follow-up of 12.2 ± 5.9 months, the observed rate of upper ureteric stricture was lower in the intervention group than in the control group, although this difference did not reach statistical significance (1/80, 1.25% vs. 4/80, 5%; p = 0.367). Similarly, a higher rate of residual stone fragments was seen on follow-up imaging at 3 months in the control group (p = 0.002). There were no differences in the duration of procedure or follow-up unscheduled admissions between the groups. Intervention: RELOADUS is a technique where impacted upper ureteric stones are relocated into renal pelvis, dusted using laser and then suction applied to achieve complete clearance. Conclusions: The RELOADUS technique appears to be a feasible and safe management strategy for impacted upper ureteric stones. By relocating impacted stones from the narrow ureter to the more capacious renal pelvis and utilising laser dusting with suction, the approach achieved high stone-free rates while aiming to reduce laser activation and instrumentation within the ureter. Larger prospective studies are required to confirm its effect on ureteric stricture formation.
SN - 0036-9330
SN - 2045-6441
ER -