Semirigid ureteroscopy: a new genre.

The semirigid ureteroscope has a diameter of 7.2F for the distal 11 cm. and gradually enlarges to 11.9F at the proximal portion. We inserted the device in the ureter of 50 consecutive patients without the need for ureteral dilation. The instrument has 2, 0.025-inch channels (2.1F) for wires (0.025), irrigation or 250 mu. laser fibers. Flexible optical fibers and a metal sheath allow for handling as with a rigid instrument, with 2 inches of flexure at the tip without loss of vision. The instrument was inserted successfully in 26 of 27 female patients (lower ureter in 13 of 13, mid ureter in 4 of 4 and upper ureter in 9 of 10), and 14 of 23 male patients (lower ureter in 8 of 10, mid ureter in 4 of 8 and upper ureter in 2 of 5). The semirigid ureteroscope may be used for laser fragmentation of ureteral calculi in almost all female patients and in some male patients. It may be used in strictured and otherwise impassable ureters, for placement of guide wires in the intramural tunnel and to examine the entire ureter atraumatically in most female and some male patients. The device has been designed specifically for laser lithotripsy, and its development expands the indications and facility with which this technology may be used.