The Initial Experience with Transurethral Ureteroscopic Lithotripsy

Lee, Jeong Eoo; Chung, Moon Kee; Yoon, Jin Han; Yoon, Jong Byung

Abstract

Between august 1986 and march 1988, 75 transurethral ureteroscopic lithotripsies were performed in 65 patients with 69 ureters. Analyzed sequentially, removal was successful in 40.6 per cent among the initial 30 patients(32 ureters) and in 81.1 percent among the subsequent 35 patients(37 ureters). The overall success rate was 62.3 percent. The common causes of failure were; Upward migration of stone, difficult ureteroscopic maneuvers to retch calculi, failure of ureteroscopic insertion in order. Of complications, 3 cases of ureteral perforation and 2 cases of ureteral avulsion were most severe. In one case who has circumferential denudation of ureteral mucosa with no urine flow in ureter, the ureteral orifice was noted with marded adhesion and total obstruction. To prevent this kind of complication, ureteral stenting is thought to be indicated. Even in the case of successful transurethral ureteroscopic lithotripsy without any immediated complications, the long-term follow-up will be necessary to detect late complications such as disturbance of peristalsis or VUR due to the fibrotic changes of ureter resulted from the insertion of ureteroscope.