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Flexible ureteroscopy is a highly resolving surgery which is able to solve most renal lithiasis of any Urology Department, with very low economic impact. It is a technique that has helped to continue treatment when SWL couldn't, and also has reduced the number of percutaneous renal surgeries that we currently perform. In this paper, we try review three important features of the operation: Technique, minimal requirements that we need to perform this surgery in a Urology Department, and the different possibilities to treat the lithiasis with holmium laser. We want to show how to perform the surgery successfully and advise what instruments and other surgical materials we really need to purchase. It is totally proved that this is a minimal invasive technique, with reasonably low cost and highly effective.

Introduction: Clavien-Dindo classification system has been proposed to grade perioperative complications in percutaneous nephrolithotomy. The complications of this technique that have taken place in the last 2 years are reported in this paper according Clavien-Dindo classification., Materials and Methods: Between 2011 and 2012 a total of 255 percutaneous nephrolithotomy were performed at our center for stones more than 2 cm in size. In order to determine the incidence of complications classified in the modified Clavien-Dindo system, statistical analysis of the data obtained was carried out., Results: During the period analyzed, 255 percutaneous nephrolithotomy were performed in 249 patients, 41% of the right side, 57% of the left side and 2% bilateral and simultaneous. 137 and 112 patients were males and females, respectively. The most prevalent comorbidities were: hypertension (AHT) in 101 patients (40.6%), BMI>30 in 81 patients (32%), diabetes mellitus in 46 patients (18.5%) and coagulation abnormalities in 24 patients (9.6%). A total of 70 cases (27.4%) were distributed according to Clavien-Dindo classification: grade i, 8.4%, grade ii 8.4%, grade iiia 4.4%, grade iiib 6% grade iva .8%, grade ivb: 0% and grade v 0%., Conclusions: A graded classification scheme for reporting the complications of percutaneous nephrolithotomy is useful for monitoring and reporting outcomes. We propose a standardized use of this classification in order to make the results comparable among different centers performing the technique., (Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)