Ureteroscopic Lithotripsy under Local Anesthesia: Analysis of the Effectiveness and Tolerability

Park, Hyoung Keun; Paick, Sung Hyun; Oh, Seung June; Kim, Hyeon Heo

Abstract

PURPOSE: This study attempted to evaluate the feasibility and effectiveness of ureteroscopic lithotripsy under local anesthesia.
MATERIALS AND METHODS
Two hundred patients(male 91; female 109) underwent ureteroscopic lithotripsy under local anesthesia; and the results evaluated. Pain perception during the local ureteroscopic procedure was compared with that of cystoscopy, using a visual analogue pain scale(semantic differential) recorded by the patient(0-no pain; 10-maximal pain).
RESULTS
The overall success rate was 93%(185/200). The success rates of upper, mid and lower ureteral stones were 83(5/6), 78(14/18) and 94%(166/176), respectively. The success rates in stones less than 10mm and more than 10mm were 94 (166/176) and 86%(30/35), respectively. There were 5 cases(3%) of complications: ureteral injury(1), pyelonephritis(2) and ureteral stricture(2). Although the mean pain scale score was higher in the ureteroscopy(3.33+/-1.75) than the cystoscopy group (3.13+/-1.92), this was not statistically significant(p>0.05). Most of the patients tolerated the pain during the procedure, with only two requiring general anesthesia. The postoperative pain was also tolerable in most patients, with only 8(4%) requiring more analgesics after the procedure.
CONCLUSIONS
The effectiveness and morbidity of ureteroscopic lithotripsy, under local anesthesia, was found to be comparable with many other previous reports, and most of the patients could tolerate the pain of the procedure. Therefore, ureteroscopic lithotripsy can be performed effectively and safely under local anesthesia.