Ureteroscopic Removal of Mid and Proximal Ureteral Calculi

Abstract

Our series demonstrates the high success rate that can be achieved with ureteroscopic removal of mid and proximal ureteral calculi. Thus, ureteroscopic treatment should be considered a treatment of choice for upper ureteral calculi.

Ureteroscopy in the Treatment of Ureteral Stones: Over 10 Years’ Experience

“…Not all deposits, especially the impacted ones, can be passed spontaneously even though the have been broken by ESWL. That prolongs the duration of treatment and increases its costs, which is consistent with the opinion of Erhard et al [18]. Handled by an experienced specialist, URS is the most effective and least expensive of the current methods of treatment, which has been confirmed by Adolfsson et al [19], Wolf et al [20]and Grasso et al [20]on the basis of recent experience and retrospective studies.…”

“…From our experience it also follows that the ultimate results of ureteral lithotripsy are not dependent on the section where the stone is situated, but generally the procedure is easiest when the stones is located in the lower portion of the ureter [18, 19]. …”

Primary Endoscopic Treatment of Ureteric Calculi

“…The cost of one treatment was similar between ESWL and ureteroscopy. Erhard et al [1]presented their experience with 78 patients who underwent ureteroscopy for iliac or pelvic ureteral stones. 55% of the patients had already been submitted to different treatments.…”

“…The stratification of the results for the stone site, compared to those achieved with shock-wave lithotripsy [1, 14, 15, 16, 17, 18, 19, 20, 21], show that the one-session solution is more common in the iliac and especially lower ureter and that the accidental push up is not uncommon for the upper ureteric stones (table 3). For this purpose, irrigation should be kept to a minimum until the stone is reached and possibly entrapped within a basket.…”

“…During the last decade the advances in technology of flexible and small-diameter rigid ureteroscopes have induced important changes in the management of ureteral calculi [1]. After the introduction of miniscopes we proposed routine ureterolithotripsy as a treatment of choice for mid and lower ureteral stones, leaving ESWL an option for patients who preferred to avoid any instrumentation and/or anesthesia.…”