1987 Volume 78 Issue 11 Pages 1917-1922
One hundred and eighteen patients with ureteral calculi were treated by transureteral lithotripsy using a rigid ureteroscope between March, 1985 and Nov., 1986. Two Patients had calculi in the bilateral ureters. Most calculi were disintegrated by the ultrasonic lithotripsy and/or electrohydroliclithotripsy and were removed by stone basket under direct vision. 122 procedures were performed for the removal of ureteral stones. Stones were removed completely in 93 procedures (76%) and imcompletelo in 8 procedures (7%). The stone could not be removed in 21 procedures (17%). Immediate complications were ureteral avulusion in 2 procedures and ureteral perforation in 10. In 3 of 12 patients with immediate complications, open surgery was necessary. which were ureteroneocystostomy, ureteroureterostomy or draingage and nephrostomy. Postoperative complications were pyrexia in 7 patients, acute prostatitis in 2, bladder tamponade in 1 and ureteral stricture in 1, who was treated with the psoas bladder hitch and ureteroneocystostomy. In the follo-up with excretroy urogram in 23 patients, the obstructive change in ureteral end arising from the insertion of the ureteroscope to the ureter, disappeard with in 4-16 weeks after procedures.
This procedure has great advantages in removing ureteral calculi, compared with percutaneous nephroscopic procedure or ureterolithotomy. However, it could not yield a complete success in the removal of calculi in the middle or the upper ureter. It also has complications requiring open reconstructive surgery. Therefore, the indication of this procedure should be necessary with more discussion.
