Ureteroscopic treatment of ureteral lithiasis with pneumatic lithotripsy: analysis of 287 procedures in a public hospital.

Ureteroscopes and different lithotripsy methods have greatly improved the urologist's ability to treat ureteral stones, regardless of their location in the ureter. We retrospectively reviewed our experience with ureteroscopic pneumatic lithotriptor in 287 patients with ureteral calculi. Ureteroscopic stone treatment was performed between October 1999 and May 2004. Of 221 patients with distal ureteral calculi, 209 (group 1), and 58 of 66 patients with upper ureteral calculi (group 2) were treated successfully by ureteroscopy alone. In group 1, seven migrated stones (to the upper urinary tract) were successfully treated by ESWL later. There were five-treatment failures due to ureteral perforation which consequently required open ureterolithotomy. In group 2, there were five patients with migrated stones; two of them were sent to a percutaneous nephrolithotomy center because of previously unsuccessful ESWL attempts. Three of these with migrated stones were treated by ESWL later. In three patients, we switched to open ureterolithotomy because of ureteral rupture that required surgical repair. Ureteroscopic pneumatic lithotripsy is a safe and effective treatment modality for ureteral calculi.