Ureteroscopy for management of distal ureteral calculi : long-term follow up

الملخص EN

Ureteroscopy as the primary treatment for distal ureteral calculi has been supported by many investigators as a highly successful and minimally invasive procedure with least morbidity in trained hands.

We report our experience with the ureteroscopic management of distal ureteral calculi (that is below the bony pelvis).

A total of 566 patients have been treated during a 4-year period from 1997 to 2000 at Al-Hussien University Hospitals.

Stone size ranged from 0.5 to 1.8 cm (mean 1.1cm).

The overall ureteroscopic success rate for stone clearance was (95.2%).

Proximal stone migration occurred in 2.7% of the patients while perforation occurred in 2.7% and mucosal trauma was diagnosed in 7.3%.

Early postoperative morbidity included fever (17.5%), loin pain (11%), hematuria (10.5%), non-surgical residual fragments (that is 2 mm or smaller) in 8% of the patients, and temporary vesicoureteral reflux in 5 patients (3.5%).

A total of 141 patients were available during the follow up period (ranging from 3 to 38 months with a mean of 8.4 months).

Stricture lower ureter was diagnosed in 3 patients (2.1%).

We believe that using small rigid endoscopes with pneumatic lithotripsy is reasonable first line of treatment for the management of patients with lower ureteric calculi.

Early and late follow up is mandatory for early diagnosis and treatment of post-ureteroscopy complications.