Long-term results of transurethral lithotripsy with the rigid ureteroscope: injury of intramural ureter.
We treated 208 patients with ureteral calculi via transurethral lithotripsy using the rigid ureteroscope between March 1985 and April 1988. A total of 220 ureteroscopic procedures was performed in 217 ureters. Complete removal was achieved after 180 procedures (81.8%) and incomplete removal was achieved after 9 (4.1%). In 31 cases (14.1%) the stone could not be removed because of various reasons. Ureteral disruption was observed in 1 case (0.5%), which was treated successfully with reconstruction. Ureteral perforation occurred in 15 cases (6.8%) and was treated successfully except for 1 patient (0.5%) in whom ureteral stricture was observed requiring reconstruction. From long-term followup of sequential excretory urography and voiding cystography, mild stricture at the vesical end of the ureter was noted in 3 of 86 ureters (3.5%) and vesicoureteral reflux was noted in 7 of 73 (9.6%). These results indicate that the injury to the intramural ureter might arise from the passage of the ureteroscope resulting in stricture and vesicoureteral reflux.
Ono
Y
Y
Department of Urology, Komaki Shimin Hospital, Japan.
Ohshima
S
S
Kinukawa
T
T
Matsuura
O
O
Hirabayashi
S
S
Yamada
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014513:Ureter / Q000293:injuries*; D014514:Ureteral Calculi / Q000628:therapy*; D014517:Ureteral Obstruction / Q000209:etiology / Q000628:therapy; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D014567:Urography; D014950:Wounds, Penetrating / Q000209:etiology