A Clinical Observation on Lower-third of Ureteral Calculi

Shin, Dong Myung; Cho, Jae Heung

Abstract

A clinical observation was made on 253 cases of lower one-third ureteral calculi among the total number of 1,438 in-patients admitted in the Department of Urology, Seoul Adventist Hopsital during the 7 years and 5 months from January 1975 to May 1982. The results of this observation are summarized as follows: 1. Among the total admissions (1,438 cases), those with urolithiasis were 406 cases (28.2%) and with lower 1/3ureteral calculi were 253 cases (62.3%). 2. The highest incidence on age distribution showed in 21 to 40 years (58.5%) and the sex ratio of male and female was about 1.3:1. 3. The most favored predirection of ureteral stone was lower 1/a of ureter in approximately 62.3% of all casesand the ratio between right and left was about 1.13:1. 4. The clinical symptoms of lower 1/3 ureteral stone showed lower abdominal pain in 93.7%, flank pain in 90.5%, nausea and vomiting in 56.1%, gross hematuria in 47.4% and vesical irritability in some cases. 5. Microscopic hematuria was presented in 87.7% and pyuria in 63.6%. 6. In lower 1/3 ureteral stones, hydronephrosis with or without functional deterioration was detected in 87.7%on excretory urograms, among them, moderate or marked hydronephrosis presented in 45.9%. 7. The most common size, below 0.5 cm in its diameter. 8. The Treatments of lower 1/3 ureteral stone were primary stone dislodger application and indwelled Dormia stone basket in 100 cases (39.5%), ureterolithotomy in 80 cases (31.6%), conservative treatement and spon-taneous expelling in 73 cases (28.9%). 9. The success rate of primary stone dislodger and indwelling of Dormia stone basket showed former in 45.8%, latter in 87.8%. 10. The mean duration of hospitalization was primary stone dislodger in 2.4 days, indwelled Dormia stonebasket in 4.8 days, ureterolithotomy in 13.4 days and conservative treatment in 3.6 days.