BACKGROUND AND PURPOSE: The optimal treatment option for ureteral calculi is a controversial issue. In this study, we present our experience of 60 patients, divided into three groups, who were treated using open surgery, laparoscopic surgery, or transureteral lithotripsy (TUL). PATIENTS AND METHODS: We enrolled 60 patients who had upper ureteral calculi >l0 mm in diameter from June 2008 to August 2009 in our center. In a prospective study, preoperative and postoperative data were evaluated, and for statistical analyses, the chi-square test, one-way analysis of variance, and post hoc test were used. RESULTS: The mean operative time was 70, 191, and 162.5 minutes in the TUL, laparoscopic, and open groups, respectively. The mean hospital stay was 1.65, 4.2, and 4.35 days in the three groups, respectively. The stone-free rate was 90%, 95%, and 100% in the three groups, respectively. Flank pain was reported as 15%, 5%, and 15%, in the three groups, respectively. Hemoglobin decrease necessitating blood transfusion was not reported in the TUL and laparoscopic groups, but blood transfusion was reported in 15% in the open group. The lowest dose of analgesic was used in the TUL group. There was no damage to the ureter and adjacent organs and wound infection in the three groups. CONCLUSION: Our study showed that the complications after laparoscopic surgery were lower than in open surgery. We recommend laparoscopic surgery for upper ureteral stones >1 cm because of lower postoperative complications, shorter hospital stay, and shorter time to convalescence, and better cosmetic results.
BACKGROUND AND PURPOSE: The optimal treatment option for ureteral calculi is a controversial issue. In this study, we present our experience of 60 patients, divided into three groups, who were treated using open surgery, laparoscopic surgery, or transureteral lithotripsy (TUL). PATIENTS AND METHODS: We enrolled 60 patients who had upper ureteral calculi >l0 mm in diameter from June 2008 to August 2009 in our center. In a prospective study, preoperative and postoperative data were evaluated, and for statistical analyses, the chi-square test, one-way analysis of variance, and post hoc test were used. RESULTS: The mean operative time was 70, 191, and 162.5 minutes in the TUL, laparoscopic, and open groups, respectively. The mean hospital stay was 1.65, 4.2, and 4.35 days in the three groups, respectively. The stone-free rate was 90%, 95%, and 100% in the three groups, respectively. Flank pain was reported as 15%, 5%, and 15%, in the three groups, respectively. Hemoglobin decrease necessitating blood transfusion was not reported in the TUL and laparoscopic groups, but blood transfusion was reported in 15% in the open group. The lowest dose of analgesic was used in the TUL group. There was no damage to the ureter and adjacent organs and wound infection in the three groups. CONCLUSION: Our study showed that the complications after laparoscopic surgery were lower than in open surgery. We recommend laparoscopic surgery for upper ureteral stones >1 cm because of lower postoperative complications, shorter hospital stay, and shorter time to convalescence, and better cosmetic results.
Authors: Ahmed S El-Abd; Ahmed M Tawfeek; Shawky A El-Abd; Tarik A Gameel; Hasan H El-Tatawy; Magdy A El-Sabaa; Mohamed G Soliman Journal: Arab J Urol Date: 2021-11-26