[Value of laser ureteroscopy with semi-rigid ureteroscope in the treatment of stones less than 2 cm situated above the iliac vessels : Report of a retrospective series of 460 consecutive cases].
OBJECTIVE
To evaluate the value of retrograde ureteroscopy in the treatment of stones less than 2 cm situated above the iliac artery.


METHODS
Between September 1989 and December 1998, 460 consecutive patients, aged 14 to 86 years, presenting with stones situated above the iliac vessels and measuring less than 2 cm were initially managed by fine (7.5 F) semi-rigid ureteroscopy with CANDELA laser fragmentation in the majority of cases. All operations were performed under general anaesthesia with continuous muscle relaxation. The operation was performed by the same operator in every case. In 50 cases (10.65%), a complementary extracorporeal lithotripsy session was performed following the operation and in 13 cases (2.82%) a second ureteroscopy was necessary.


RESULTS
352 patients (76.5%) were free of any residual fragments after a single laser ureteroscopy session. 415 patients (90.21%) were free of any stone fragments at the 3rd postoperative month. Complications consisted of 28 cases of ureteric perforations, which were all cured by double J stenting, and 7 cases of minor haematuria during the operation. No long-term complication was observed.


CONCLUSIONS
Ureteroscopy with laser lithotripsy using a fine, semi-rigid instrument, is a reliable technique to treat stones situated above the iliac vessels, provided appropriate anaesthesia and continuous muscle relaxation are ensured. This procedure is associated with a low morbidity and therefore constitutes an effective alternative in the case of failure of ESWL for the treatment of stones less than 2 cm situated above the iliac vessels.
Fédération d'Urologie Néphrologie, Hôpital Pasteur, Nice, France. urologie@chu-nice.fr
Frédéric
F
Colomb
Timotée
T
Kambou
Bruno
B
Pebeyre
Daniel
D
Chevallier
Jacques
J
Toubol
Jean
J
Amiel
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007083:Iliac Artery; D007669:Kidney Calculi / Q000628:therapy*; D017602:Lithotripsy, Laser / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018666:Ureteroscopy / Q000379:methods