Ureteroscopy in the treatment of ureteral calculi : efficacy and safety

الملخص EN

Objectives : To present our experience with ureteroscopy for the treatment of ureteral calculi.

Methods : A retrospective review of 904 ureteroscopies for ureteric lithiasis performed in 810 patients (mean age 39.3 years ; range 14-70 years ; 485 males, 325 females) at Prince Hussein Bin Abdullah Urology Center between January 2006 and January 2008 was conducted.

A 9.5F rigid ureteroscope was used in all patients.

Pneumatic lithoclast was used to fragment stones and the fragments were retrieved with forceps and / or baskets.

Hospital and follow-up records of the patients were reviewed in this study.

Success and complication rates are presented.

Results : Sixty one (7.5%) of the stones were located in the upper, 204 (25.2%) in the middle and 545 (67.3%) in the lower ureter.

The size of the stones treated ranged between five to 20 mm.

Ureteroscopy resulted in successful stone removal in 750 patients (92.6%).

Six hundred and fifty six stones were treated in a single session.

Repeat ureteroscopy was performed in 94 patients (11.6%).

In 53 patients (6.5%) the stones were pushed up and successfully underwent ESWL.

Antegrade renoureteroscopy was performed in three cases of ureteroscopy failure for fixed upper ureteric stones.

A total of four patients with ureteroscopy failure were referred for open surgery.

Gross hematuria was observed in eight (1.0%) patients, 15 (1.9%) patients suffered from postoperative fever for an average of two days (range 1-4 days), 17(2.1%) patients had persistent renal colic.

Nine cases (1.1%) of ureteral perforation were successfully treated by JJ stent, and only one case of ureteral avulsion (upper ureter) was treated by open surgery.

Four cases of postoperative ureteral stricture have been observed.

Conclusion : On the basis of our experience, ureteroscopy is an effective interventional modality for ureteric stones with a low complication rate.