title: Ureteroscopic treatment of multiple distal-ureteral stones.
abstract: OBJECTIVE
  Ureteroscopic intracorporeal lithotripsy for solitary distal-ureteral stones may be considered a first-line therapy. However, few reports that mention ureteroscopic procedures for multiple ureteral stones were found in the literature. Retrospectively, we reviewed our patients who were treated by ureteroscopy for multiple distal-ureteral stones.
  
  
  METHODS
  Fifteen patients underwent ureteroscopic pneumatic lithotripsy for unilateral multiple distal-ureteral stones. Ten patients had two stones, four patients had three stones, and another patient had five stones. The average stone number per ureteral unit was 2.44, and the average stone size was 9.7 mm (range 3-23 mm).
  
  
  RESULTS
  Eighty percent of the patients (12/15) who had unilateral stones were stone free after the first session of ureteroscopic pneumatic lithotripsy. Two patients underwent a second ureteroscopy procedure for the remaining stone or failure of ureteral access. Overall, 93.3% of the patients (14/15) were stone free. Ureteral perforation as a major complication occurred in one patient (6.6%), who was treated by open surgery. We did not routinely use Double-J ureteral stents after ureteroscopy. Only one patient required stenting because of failure of ureteral access. Steinstrasse was observed in three patients, but it resolved spontaneously in the early postoperative period.
  
  
  CONCLUSIONS
  Ureteroscopic pneumatic lithotripsy has a high success rate with few complications for the treatment of unilateral multiple distal-ureteral stones. Ureteroscopic pneumatic lithotripsy seems very effective for such stones.
authors.affiliation: Department of Urology, Vakif Gureba Hospital, Istanbul, Turkey. gokhangurbuz@yahoo.com
authors.forename: Zafer Gökhan
authors.initials: ZG
authors.lastname: Gürbüz
authors.forename: Saban
authors.initials: S
authors.lastname: Mimaroglu
authors.forename: Levent
authors.initials: L
authors.lastname: Gürkan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Oder
authors.forename: Levent
authors.initials: L
authors.lastname: Verim
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014514:Ureteral Calculi / Q000601:surgery*; D018666:Ureteroscopy / Q000009:adverse effects / Q000379:methods*