Özet:

Today, the first stage of treatment of distal producer stones is rijid producerenoscope. However, the standard treatment of proximal producer stones is still to be discussed. In recent years, proximal producer has taken its place in literature in which flexible produceroscopy can be successfully applied. In this study, we present the results of the flexible producerenoscopy applied to proximal producer stones in our clinic. The study included 28 patients who studied the hospital records and all the data could be accessed. All patients have preoperative urine cultures. The balloon dilatation was performed on the productive orifies of patients without preoperative diversion. The flexible produceroscope (Olympus URF-P5) was introduced into the system, advanced through the guideline wire, and according to the surgeon's preference in different power settings, the stone breaking process was carried out with the same holmium laser. Patients after the procedure were assessed with direct urine system graphics, ultrasound, intravenous pyelography when required by computer tomography. The average age of patients was 41 (22-84); 15 (53.6%) men and 13 (46.4%) women. 25 stone radiopacks, 1 stone semi-opacks, 2 stone non-opacks, 16 on the right collection system, 12 on the left collection system were initiated. 13 (53.6) patients were given pre-treatment swl. The average size of the stone was 105mm2 (49-400mm2). 11 (39.3%) patients had a pre-operative djs. The average duration of the surgery was 45 minutes (35-80). During the procedure, 18 patients (64.3%) were found to have anclave stones. Postoperative 4 patients (14.3%) did not use diversion while again 4 patients (14.3%) were placed catheters producing and the first day was withdrawn. 20 patients (71.4%) were placed in djs. In the postoperative assessments, no remaining stone was identified in all patients. In two patients (7.1%), no other complications were observed while urinary infection was observed in the early period. Flexible produceroscopy is a method that can be applied with high success and a minimum rate of complications in proximal producer stones, including anklavic stones. TREATMENT OF PROXIMAL URETER STONES LESS THAN TWO CENTIMETERS WITH FLEXIBLE URETERENOSCOPY ABSTRACT: The first-line treatment of distal ureteral stones is rigid ureterenoscopy. However, the standard treatment of proximal ureteral stones is still controversial. In recent years, proximal ureteral stones can be managed with flexible ureterenoscopy (F-URS) successfully. This study presents results of F-URS due to the proximal ureteral stones in our clinic. 28 patients with access to all data were included in the study. Preoperative urine cultures were performed for all patients. Balloon dilatation of the ureteral orifice was done for patients without urinary diversion. Flexible ureterenoscope (Olympus URF-P5) was introduced over the wire and with different power settings of laser was applied according to the surgeon's preference. After the procedure, patients were evaluated x-ray graphics, intravenous urography, ultrasonography and computed tomography when necessary. The average age of patients was 41 (22-84). 15 of patients (53.6%) were male and 13 of patients (46.4%) were female. 25 of stones were radiopaque, 1 stone was semi-opaque, and 2 of stones were non-opaque while 16 of access was made on the patients' right ureter and 12 of access was made on the patients' left ureter.  SWL was performed in 13 patients (53.6%) before the procedure. Mean stone size was 105mm2 (49-400mm2). Eleven patients (39.3%) had double j stent before the procedure. Mean operative time was 45 minutes (35-80). During the operation, in 18 patients (64.3%) it was found to be completely obstructive stone. Postoperatively diversion was not used for 4 patients (14.3%), ureteral catheter placement was used for 4 patients (14.3%), which were pulled out on the first day. Double j stent was the choice of diversion on 20 patients (71.4%). There were no residual stones in all patients after the evaluation process. Urinary tract infection was the complication in two patients (7.1%) while other complications were not observed. Flexible ureterenoscopy is a reliable method with a high success rate and minimal complications in proximal ureteral stones. Keywords: Ureter stone, Flexible ureterenoscopy