Ureteroscopic lithotripsy under local anesthesia: analysis of the effectiveness and patient tolerability.
OBJECTIVE
We tried to evaluate the feasibility and effectiveness of ureteroscopic lithotripsy under local anesthesia.


METHODS
We evaluated the results of ureteroscopic lithotripsy under local anesthesia performed on 200 patients (male 91; female 109). We compared the pain perception during local ureteroscopic procedure to that of cystoscopy using a visual analogue pain scale recorded by the patient.


RESULTS
The overall success rate was 93% (185/200). The success rates of the upper, mid and lower ureteral calculi were 83% (5/6), 78% (14/18), and 94% (166/176), respectively. The success rate was 94% (166/176) in calculi less than 10 mm, and 86% (30/35) in those more than 10 mm. There were 5 cases (3%) of complications: ureteral injury (1), pyelonephritis (2), and ureteral stricture (2). Although the mean pain scale score was higher in the ureteroscopy group (3.36+/-1.75) than in the cystoscopy group (3.13+/-1.92), the difference between the two groups was not statistically significant (p>0.05). Most of the patients tolerated pain during the procedure and only two patients required general anesthesia. Postoperative pain was also tolerable in most patients and only 8 (4%) patients required additional analgesics after the procedure.


CONCLUSIONS
As the effectiveness and morbidity of ureteroscopic lithotripsy under local anesthesia are comparable to those of many other previous reports and as most of the patients could tolerate the pain of the procedure, we suggest that ureteroscopic lithotripsy can be performed effectively and safely under local anesthesia.
Park
Hyoung Keun
HK
Department of Urology, Seoul National University College of Medicine and Clinical Research Institute, Seoul National University Hospital, 28 Yongon Dong Jongno Ku, Seoul 110-744, Republic of Korea.
Paick
Sung Hyun
SH
Oh
Seung-June
SJ
Kim
Hyeon Hoe
HH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000772:Anesthesia, Local; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D018666:Ureteroscopy / Q000009:adverse effects