Moreno AJ, Montoya MG, Lizárraga SJF, Leal MRA

Language: English
References: 27
Page: 32-35
PDF size: 46.56 Kb.

ABSTRACT

Although ureteroscopy has become a routine procedure in most urologic centers it is still mainly done as an inpatient procedure. Since 1992 we have done our ureteroscopies as an outpatient procedure. We report 186 consecutive cases of patients treated endoscopically for ureteral calculi using an 8.5 Fr rigid ureteroscope and separated into four groups according to the fragmentation device: 1) alexandrite laser, 2) electrohydraulic, 3) ultrasonic and 4) pneumatic lithotriptors. The overall success rate was 85.5%, 91.6% for distal and mid ureteral calculi and 76.9% for upper ureteral calculi. Laser lithotripsy was the most effective in distal and mid ureter and pneumatic was the most effective in upper ureteral stones. The overall complication rate was 8.1%. Only 4 patients (2.15%) required hospitalization. Our results support the concept of ureteroscopy for the treatment of ureteral calculi as a safe outpatient procedure. Hospitalization should only be reserved for patients with preexisting medical problems or complications arising during ureteroscopy.

REFERENCES

1. Blute LM, Segura JW, Patterson DE. Ureteroscopy. J Urol 1988; 139: 510.

2. Daniels GF, Gamett JE Jr, Carter MF. Ureteroscopic results and complications: Experience with 130 cases. J Urol 1988; 139: 710.

3. Seeger AR, Rjttenberg MH, Bagley D. Ureteroscopic removal of ureteral calculi. J Urol 1988; 139: 1180.

4. Lingeman JE, Sonda LP, Kahnoski RJ et al. Ureteral stone management: Emerging concepts. J Urol 1988; 135: 1172.

5. Politis G, Griffith D. Ureteroscopy in Management of Ureteral Calculi. Urol 1987; 30: 39.

6. Pérez-Castro EE, Martínez-Pineiro JA. Transurethral ureteroscopy: a current urological procedure. Arch Exp Urol 1980; 33: 445.

7. Sosa RE, Vaughan ED Jr. Complications of ureteroscopy. AUA update series 1988; 7: 35.

8. Keating MA, Heney NM, Young HH et al. Ureteroscopy: The initial experience. J Urol 1986; 135: 689.

9. Schuster TG, Hollenbeck BK, Faerber GJ et al. Complications of ureteroscopy: Analysis of predictive factors. J Urol 2001; 166: 538.

10. Harmon WJ, Sershon PD, Blute ML et al. Ureteroscopy: Current practice and long-term complications. J Urol 1997; 157: 28.

11. Wei Zheng W, Denstedt JD. Intracorporeal lithotripsy: Update on technology. Urol Clin North Am 2000; 27: 2.

12. Wills TE, Burns JR. Ureteroscopy: An outpatient procedure? J Urol 1994; 151: 1185.

13. Boline GB, Belis JA. Outpatient fragmentation of ureteral calculi with mini-ureteroscopes and laser lithotripsy. J Endourol 1994; 8: 341.

14. Sun Y, Wang L, Liao G et al. Pneumatic lithotripsy versus laser lithotripsy in the endoscopic treatment of ureteral calculi. J Endourol 2001; 15(6): 587.

15. Huang S, Patel H, Bellman GC. Cost effectiveness of electrohydraulic lithotripsy versus Candela pulsed-dye laser in management of the distal ureteral stone. J Endourol 1998; 12(3): 237.

16. 16 Jung P, Wolff JM, Mattelaer P et al: Role of lasertripsy in the management of ureteral calculi: experience with alexandrite laser system in 232 patients. J Endourol 1996; 10(4): 345.

17. Pearle MS, Sech SM, Cobb CG et al. Safety and efficacy of the alexandrite laser for the treatment of renal and ureteral calculi. Urol 1998; 51(1): 33.

18. Willscher MK, Conway JF Jr, Babayan RK et al. Safety and efficacy of electrohydraulic lithotripsy by ureteroscopy. J Urol 1988; 140: 957.

19. Rodrígues-Netto N Jr, Ikonomidis J, Zillo C. Routine ureteral stenting after ureteroscopy for ureteral lithiasis: Is it really necessary? J Urol 2001; 166: 1252.

20. Begun FP, Jacobs SC, Lawson RK. Use of a prototype 3 F electrohydraulic electrode with ureteroscopy for treatment of ureteral calculous disease. J Urol 1988; 139: 1188.

21. Abdel-Razzak OM, Bagley DH. Clinical experience with flexible ureteropyeloscopy. J Urol 1992; 148: 1788.

22. Bagley MD. Removal of upper urinary tract calculi with flexible ureteropyeloscopy. Urol 1990; 35: 412.

23. Grasso M, Loisides P, Beaghler M et al. The case for primary endoscopic management of upper urinary tract calculi: A critical review of 121 extracorporeal shock-wave lithotripsy failures. Urol 1995; 45: 363.

24. Grasso M, Bagley DH. A 7.5/8.2 F Actively Deflactable, Flexible Ureteroscope: A new device for both diagnostic and therapeutic upper urinary tract endoscopy. Urol 1994; 43: 435.

25. Assimos DG, Patterson LC, Taylor CL. Changing incidence and etiology of iatrogenic ureteral injuries. J Urol 1994; 152: 2240.

26. Grasso M, Beaghler M, Loisides P. The case for primary endoscopic management of upper urinary tract calculi: II. Cost and outcome assessment of 112 primary ureteral calculi. Urol 1995; A5: 372.

27. Abdel-Razzak OM, Bagley DH. The 6.9 F Semirigid Ureteroscope in Clinical Use. Urol 1993; 41: 45.