title: Emergency ureteroscopic management of ureteral stones: why not?
abstract: OBJECTIVE
  To describe a single-center experience in the emergency ureteroscopic management of ureteral stones.
  
  
  METHODS
  We retrospectively considered the data from 144 patients (mean age 49.6 years, range 23 to 82) who had had obstructive ureteral stones and had undergone emergency ureteroscopy with stone retrieval. Intracorporeal pneumatic lithotripsy was performed when necessary. At the end of the procedure, a ureteral catheter was systematically left in place in 100 patients (69.4%) and removed within 24 hours. In the remaining 44 patients, a double-J stent was preferred and was removed within 30 days, depending on the clinical course. Stone-free status was defined as the complete absence of fragments at 1 month of follow-up.
  
  
  RESULTS
  The calculi were more frequently localized in the distal ureter than in the proximal one (90.3% versus 9.7%, respectively). The overall mean stone diameter was 9.1 mm (range 5 to 20). The overall stone-free rate was 92.4%. A greater stone-free rate was obtained in those with stones less than 10 mm (95.8%) than in those with stones larger than 10 mm (89%, P = 0.002). Similarly, a significantly better outcome occurred for those with stones located in the distal ureter (94.6%) than for those with stones in the proximal one (71.4%, P = 0.004). The overall complication rate was 4.2%. The mean hospital stay was 2.5 days (range 1 to 7).
  
  
  CONCLUSIONS
  In our experience, emergency ureteroscopy in cases of obstructive ureteral stones proved to be safe and effective. It has the main advantage of offering both immediate relief from pain and stone fragmentation. Additional extensive studies are warranted to corroborate these findings.
authors.affiliation: Department of Urology, Santo Antonio General Hospital, Oporto, Portugal. luis_osorio@netcabo.pt
authors.forename: Luis
authors.initials: L
authors.lastname: Osorio
authors.forename: Estevao
authors.initials: E
authors.lastname: Lima
authors.forename: José
authors.initials: J
authors.lastname: Soares
authors.forename: Riccardo
authors.initials: R
authors.lastname: Autorino
authors.forename: Rui
authors.initials: R
authors.lastname: Versos
authors.forename: Arnaldo
authors.initials: A
authors.lastname: Lhamas
authors.forename: Filinto
authors.initials: F
authors.lastname: Marcelo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014514:Ureteral Calculi / Q000150:complications / Q000628:therapy*; D014517:Ureteral Obstruction / Q000209:etiology / Q000628:therapy; D018666:Ureteroscopy