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Treatment of impacted lower third ureteral stones with the use of the ureteral access sheath

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Abstract

We present our experience with the use of the ureteral access sheath for the management of small impacted lower third ureteral stones, in comparison with more standard techniques. Ninety-eight consecutive patients, aged 18–73 years (mean 48.5), with small (diameter < or =10 mm) impacted lower third ureteral stones (<5 mm in 56, and 5–10 mm in 42 patients) were randomly managed with either a 12/14F coaxial ureteral dilator/sheath and a 7.5F flexible ureteroscope (group A; 48 patients), or with balloon dilatation and the 7.5F flexible ureteroscope (group B; 50 patients). In both groups, stones were grasped and extracted with a basket, and when necessary they were disintegrated with a 1.9F electrohydraulic lithotripsy (EHL) probe. Postoperatively, excretory urography was performed at 1 month and patients were followed-up for 1 year. The mean operative time was 45.5 min in group A, and 58.5 min in group B (P<0.05). EHL was performed in 16 (33.3%) patients of group A, and in 12 (24%) patients of group B. In group B, balloon dilatation was performed in 28 (56%) patients. Ureteral perforation was revealed in 4 (8%) patients of group B. The follow-up imaging tests showed stone-free status in 46 (95.8%) patients of group A and in all (100%) patients of group B. No long-term complications were recorded. Endoscopic management of small impacted lower third ureteral stones with the ureteral access sheath is a quicker and safer procedure, in comparison with the more standard approach, bearing comparable efficacy.

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Authors and Affiliations

  1. Department of Urology, Hellenic Airforce and V. A. General Hospital, Athens, Greece

    Nick P. Pardalidis, Athanasios G. Papatsoris, Christos G. Kapotis & Eleni V. Kosmaoglou

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  1. Nick P. Pardalidis
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  2. Athanasios G. Papatsoris
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  3. Christos G. Kapotis
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  4. Eleni V. Kosmaoglou
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Correspondence to Athanasios G. Papatsoris.

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Pardalidis, N.P., Papatsoris, A.G., Kapotis, C.G. et al. Treatment of impacted lower third ureteral stones with the use of the ureteral access sheath. Urol Res 34, 211–214 (2006). https://doi.org/10.1007/s00240-006-0044-6

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  • DOI: https://doi.org/10.1007/s00240-006-0044-6

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