Ureteroscopy at a Lithotripsy Center

Abstract

All cases involving ureteroscopy for the period of January 1, 1987, to January 1, 1988, were retrospectively reviewed. Of 97 total cases, 96 were performed with a 9.5 Fr. rigid ureteroscope. The reasons for ureteroscopy varied, including attempted basket extraction of a lower ureteral calculus (63%), evaluation of a non-negotiable ureter (13%), location of the calculus (8%), and retrieval of migrated double-J ureteral stent (5%). The treatment site was the lower ureter in 78% of cases.

The mean time for treatment was 55 minutes (range, 9 to 207 minutes). Postoperative ureteral stents were used in 75% of cases. The stents were left indwelling for various periods of time, depending on the original pathology and the judgment of the surgeon as to the degree of ureteral trauma. The mean calculous diameter successfully removed with basket extraction was 6.2 mm (range, 2 mm to 18 mm). Treatment was successful in 55% of cases. Of 31 unsuccessful cases, the most common problems encountered were inability to engage stone with the basket (11 cases), inability to negotiate ureteral orifice (7 cases), inability to visualize the calculus (6 cases), and extrusion of calculus outside the ureteral lumen (2 cases). The latter two cases were the only significant complications associated with this procedure reported during this period.

Ureteroscopy has been an important and useful tool in this active lithotripsy center. It has proven to be most effective in the diagnosis and treatment of lower ureteral pathology.