Ureteroscopy without routine balloon dilation: an outcome assessment.
A retrospective analysis of 156 rigid ureteroscopic stone procedures in 145 patients revealed successful manipulation in 90%. The stone-free rate after adjunctive procedures was 95%. Access was achieved without balloon dilation in all but 18 patients. There were 24 perforations, occurring in 31% of proximal, 8% of mid ureteral and 8% of distal stone manipulations. Of the evaluable patients 63% underwent radiographic assessment for stricture disease, 75% at 6 months or more after the procedure. The stricture rate was 3.5% in all patients and 5.9% in patients with perforations. Of 37 patients evaluated for vesicoureteral reflux only 1 had reflux. Questionnaire followup was obtained for 74% of the patients (mean followup 2.6 years) and 32% felt normal within 3 days. Postoperative symptoms included flank pain (13%), renal colic (12%), pelvic discomfort (30%) and Double-J stent related complaints (49%). Of the patients 15% have reported recurrent stones. Ureteroscopy is effective and well tolerated, and it has minimal long-term complications.
Stoller
M L
ML
Department of Urology, University of California School of Medicine, San Francisco.
Wolf
J S
JS
Hofmann
R
R
Marc
B
B
D002404:Catheterization; D019723:Endoscopes; D004724:Endoscopy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014513:Ureter; D014514:Ureteral Calculi / Q000628:therapy*