Walk-in ureteroscopy and laser management service for urolithiasis in patients with renal colic: Lessons focusing on gains and challenges

Introduction: We conceptualized a modified care pathway for renal colic management with the intention of expediting their treatment. This proof-of-concept study aimed at assessment of walk-in ureteroscopy outcomes in comparison to conservative treatment of urolithiasis with renal colic. Patients and Methods: Forty-two patients (32 in walk-in ureteroscopy group and 10 in the conservative group) with a mean age of 37 ± 10.2 years were confirmed to have ureteric/renal stones as the cause of renal colic using non-contrast computed tomography (CT) scan. Walk-in ureteroscopy and laser fragmentation procedures were offered to all. Those opting for the procedure underwent ureteroscopy and laser fragmentation. They were discharged immediately after the procedures and followed up in the clinic, including removal of stents. Patients with sepsis were excluded. Stone, free rate, and re-admission, including complications, were assessed and analyzed. Results: The mean time from CT detection to ureteroscopic laser fragmentation was 6 ± 3.4 h. All patients resumed work in 2-3 weeks and reported no further admission to hospital for stone-related events. 30 patients were stone free at a follow-up imaging at 6 weeks. One patient had a small residual stone fragment (