Impact of obesity on retrograde ureteroscopic approach

Introduction: High-grade obesity raises some specific problems regarding the endourological approach. The aim of our study was to determine if this pathology might influence the outcome of retrograde ureteroscopy. Materials and methods: We evaluated the outcome of 88 ureteroscopies performed in highly obese patients during the last 5 years. The data were compared with the results of 88 consecutive ureteroscopies performed in normal weight patients. Results: The success rate in the study group was of 91% by comparison with 95% in the normal weight group. The use of flexible ureteroscopes was imposed in 17% of the obese group vs. 11% in the control group. The complications rate (all mild) was of 6.8% in the obese group vs. 4.5% in the normal weight patients. The differences between the two groups, although present, were not statistically significant. However, in two cases with obesity, the weight of the patients was too high for the operating table, imposing supplementary sustaining measures. Conclusions: Ureteroscopic treatment of stones in obese patients is an acceptable treatment modality, with success rates similar to non-obese patients. Sometimes it may require some logistic measures in the operating theatre.