PURPOSE: To present our experience in ureteroscopic lithotripsy and stone extraction without ureteral dilatation. PATIENTS AND METHODS: A total of 134 consecutive patients (80 male and 54 female), with a mean age of 36.4 (18-65) years underwent ureteroscopic stone removal. The stones were located in the lower, middle, and upper parts of the ureter in 92, 18 and 24 patients and the mean stone diameters were 9.2 (6-15) mm, 10.5 (8-15) mm and 8.8 (8-10) mm, respectively. A semirigid ureteroscope 8 F in size was used without any ureteral dilatation. The stones were fragmented by a pneumatic lithotripter in the ureter and the fragments were removed by a basket catheter or stone forceps. All patients were re-evaluated with a plain film on postoperative first day and with intravenous urography (IVU) at 3 months. Residual fragments bigger than 3 mm were accepted as treatment failure. RESULTS: The mean operation time was 44 (20-120) minutes. After the operation, the stone-free rate was 89/92 (97%) for lower, 15/18 (83%) middle and 18/24 (75%) upper ureteral stones, respectively. Double J catheter replacement was needed in 13 patients due to impacted stone and/or failed procedure. Ureteral perforation did not occur in any patient. Patients were discharched from hospital within 6-24 hours. No ureteral stricture was encountered during the follow-up period. CONCLUSION: Our experience suggests that ureteroscopic interventions could be easily performed for all parts of ureter without previous dilatation of the ureter.
PURPOSE: To present our experience in ureteroscopic lithotripsy and stone extraction without ureteral dilatation. PATIENTS AND METHODS: A total of 134 consecutive patients (80 male and 54 female), with a mean age of 36.4 (18-65) years underwent ureteroscopic stone removal. The stones were located in the lower, middle, and upper parts of the ureter in 92, 18 and 24 patients and the mean stone diameters were 9.2 (6-15) mm, 10.5 (8-15) mm and 8.8 (8-10) mm, respectively. A semirigid ureteroscope 8 F in size was used without any ureteral dilatation. The stones were fragmented by a pneumatic lithotripter in the ureter and the fragments were removed by a basket catheter or stone forceps. All patients were re-evaluated with a plain film on postoperative first day and with intravenous urography (IVU) at 3 months. Residual fragments bigger than 3 mm were accepted as treatment failure. RESULTS: The mean operation time was 44 (20-120) minutes. After the operation, the stone-free rate was 89/92 (97%) for lower, 15/18 (83%) middle and 18/24 (75%) upper ureteral stones, respectively. Double J catheter replacement was needed in 13 patients due to impacted stone and/or failed procedure. Ureteral perforation did not occur in any patient. Patients were discharched from hospital within 6-24 hours. No ureteral stricture was encountered during the follow-up period. CONCLUSION: Our experience suggests that ureteroscopic interventions could be easily performed for all parts of ureter without previous dilatation of the ureter.
Authors: Amr Elmekresh; Lawrence Tsai; Victor Villarreal; Zain Hyder; Patrick S Lowry; Marawan M El Tayeb Journal: Proc (Bayl Univ Med Cent) Date: 2021-11-19