Abstract:

Objectives: We retrospectively evaluated our rigid ureteroscopy (URS) treatment results in ureteric stones and assessed its effectiveness concerning ureteric stone localization. Materials and methods: Overall, 101 patients were retrospectively evaluated including lower (n=69), mid (n=23) and upper ureteric (n=9) stones which were treated with rigid URS (Wolf 8.0-9.8Fr, Germany) in our hospital between January 2007 and June 2009. Stones were removed by stone forceps/basket catheter either as a single piece or fragmented by pneumatic lithotripsy (EMS-Swisslithoclast-Master). Results: Mean patient age was 45.1 (19-78) years. Stones were located in the right (n=52) and left (n=49) ure­ters, respectively. Mean stone size was 7.4 mm (5-15). Of the 9 patients with upper ureteric stones, 7 were (77.8%) stone-free. However, stone migrated into the renal pelvis in two patients but passed into ureter again in the follow-up and removed by URS. Of the 23 patients with mid-ureteric stones, 22 were (95.7%) stone-free. Ureter perforation occurred in one patient and ureteroneocystostomy was performed. Of the 69 patients with lower ureteric stones, 68 were (98.6%) stone-free. Ureter perforation occurred in one patient and healed spontaneously by ureter catheter replacement. Stone was removed afterwards by URS. Overall (n=101), ureter perforation occurred in 1.9% (n=2) in our series. Resistant urinary tract infection developed in one patient (0.9%) (P.aeroginosa). Conclusion: Due to the results of this preliminary study, rigid URS and pneumatic lithotripsy can be performed successfully in lower ureteric stones. However, as stone location shifts to upper ureter, success rate decreases. Although URS can be performed safely with low complication rates in the treatment of ureteric stones, severe complications like ureter perforation might occur.

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