Removal of upper urinary tract calculi with flexible ureteropyeloscopy.

Flexible ureteropyeloscopy is an endoscopic technique which can give access to the entire intrarenal collecting system. Retrieval instruments or lithotriptors, electrohydraulic or pulsed dye laser, can be employed. In 70 patients, 72 procedures were used to treat 77 calculi. The calculus could be reached in each patient. Previous treatment included shock-wave lithotripsy or attempts at repositioning and open surgical exploration. There were multiple calculi in 18 patients, and 3 patients weighed more than 300 pounds. Calculi were successfully removed or moved to the distal ureter in 62 of 77 cases (80.5%). The success rate was better with mid or proximal ureteral stones and renal pelvic stones than distal calculi. In 21 patients lithotripsy was employed. Flexible ureteropyeloscopy can be utilized for the successful treatment of upper urinary tract calculi.