Ureteral calculus is a common condition in urological practice. Ureteroscopic laser lithotripsy is currently widely used as the first-line therapy for stones reaching indicated size. Successful lithotripsy needs not only adept maneuver techniques but swift decision making as well. In this chapter, the author shares his experience with some of the tricks that could help fresh practitioners manage ureteroscopy faster and with fewer complications. As choice of correct equipment is crucial, this chapter lists the various ureteroscopes, guidewires, and ureteral access sheaths that are helpful in difficult cases. Then, the tips for gaining access into the ureteral orifice with a semirigid ureteroscope are delineated, as these are maneuvers to guarantee safe practice whenever resistance is encountered during passage of the ureteroscope. Lithotripsy is then described in detail to ensure maximum clearance at the first attempt. Furthermore, step-by-step maneuvers of flexible ureteroscopy are described, as these instruments are increasingly used in the minimally invasive therapy for stones in the renal pelvis and calyx. Finally, decisions on stent placement are discussed based on experience of the author’s, as well as other, institutes.
Ureteroscopy Ureteroscope Ureteral calculi Renal calculi Lithotripsy Laser Stone occlusion Stone retropulsion Guidewire Ureteral stent
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