Ureteroscopy under Intravenous Propofol Anesthesia for the Treatment of Middle and Upper Ureteral Calculi: Comparison with Lower Ureteral Calculi

Lee, Jong Wook; Jeong, Jeong Yun; Yoo, Tae Keun

Abstract

PURPOSE: Intravenous propofol anesthesia has been safely and effectively used in the ureteroscopic management of lower ureteral calculi. We investigated whether we can also use propofol anesthesia effectively for the treatment of middle and upper ureteral calculi.
MATERIALS AND METHODS
We performed ureteroscopy with intravenous propofol anesthesia in 200 consecutive patients with ureteral calculi from July 1998 to December 2001. We divided them into 2 groups. Group 1 consisted of 59 patients, 48 men and 11 women, with upper and midureteral calculi, and group 2 consisted of 141 patients, 94 men and 47 women, with lower ureteral calculi. We compared safety, success rate, length of hospital stay and complication rate between the two groups.
RESULTS
The overall success rate for ureteroscopy was 94.5% (189/200). Seven patients suffered perioperative complications, none of whom needed to change mode of anesthesia or remembered discomfort during the operation. In group 1, stone size, operation time and postoperative hospital stays were 7.5+/-3.2mm, 33.0+/-20.3 minutes and 1.9+/-1.0 days, respectively. The equivalent results were 6.2+/-2.9mm, 22.9+/-15.0 minutes and 1.4+/-0.9 days, respectively, in group 2. There were no significant differences in age, complication rate or success rate between the two groups.
CONCLUSIONS
In patients with middle and upper ureteral calculi, ureteroscopic stone removal under intravenous propofol anesthesia can be performed safely and effectively without any significant increase in morbidity or patient discomfort.