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Purpose: Since the advance of endourologic techniques and instruments, treatment of the lower ureteral stones has become highly successful and safe. Ureteroscopy is a standard urologic endoscopic procedure in treating the stones. Methods: In this study, we have reviewed the results of 70 consecutive cases treated by the guidance of rigid ureteroscope between September 1994 and June 1995. Mean calculus diameter was 5.3 mm (between 3 to 10 mm). Results: In 63 patients (90%) were stones removed successfully. They were fragmented by electrohydraulic lithotripsy in 18 (28.6%), extracted by basket catheter in 16 (25.4%) and extracted by grasping forceps in 29 (46.0%). An ureteral stent was inserted following the procedure in 36 cases (51.4%). 57 patients (81.4%) were discharged from the hospital within two days. We did not observe any serious complications. Conclusion: Urologists enjoy a variety of treatment options to manage ureteral calculi. Continuing refinements in 'minimally invasive' techniques such as ESWL, ureteroscopic stone manipulation, ureteral stents, and intracorporeal lithotripsy using various energy sources have made open surgery nearly obsolescent. The choice of optimal ureteral stone treatment must be individualized to consider patient needs, physician expertise, and treatment facilities. Our experience shows that ureteroscopic lithotripsy provide a safe and effective means of performing intracorporeal lithotripsy for smaller ureteric stones. In skilled hands, ureteroscopic lithotripsy is by far the most expeditious and low morbidity means of clearing a distal ureteral stone burden. Thus, ureteroscopic treatment should be considered a treatment of choice for distal ureteral calculi. |
