Does stone dimension affect the effectiveness of ureteroscopic lithotripsy in distal ureteral stones?
OBJECTIVE
To investigate whether stone dimension is a restrictive factor for ureterorenoscopic procedures.


METHODS
A group of 416 patients who had undergone ureterorenoscopic pneumatic lithotripsy (URS-PL) for lower ureteral stones between January 1999 and June 2006 in our clinic had been evaluated retrospectively. Two hundred and seventy (270, 64.9%) patients were men and 146 (35.1%) were women. The mean age of the patients was 36.61 (+/- 12.43) years. Patients were grouped according to stone dimension; 193 patients with stones smaller than 1 cm being group 1 and 223 patients with stones > or = 1 cm in dimension being group 2. Stone-free rate, operative time and rate of complications of the groups were compared. Pearson's correlation test, chi2 test, Fischer's exact test and Student's t-test were used for the statistical analysis. The p value was accepted as being meaningful if p < 0.05.


RESULTS
For group 1, the mean operative time was 39.19 (+/- 18.33) min. Proximal stone migration in five and false passage formation in three patients was observed. Three patients were stone-free after a second session of URS-PL. The cumulative stone-free rate was 97.4% (188/193). For group 2, the mean operative time was 48.5 (+/- 11.31) min. About 208 (93.27%) patients were stone-free after the first session and an additional eight patients became stone-free after the second session of URS-PL. False passage, ureteral perforation, ureteral avulsion and stricture were observed in four, six, one and one patients, respectively. No proximal stone migration was observed. The cumulative stone-free rate was 96.86% (216/223).


CONCLUSIONS
The effectiveness of ureterorenoscopy (URS) in the treatment of distal ureteral stones was independent of stone dimension. However, the operative time was longer and the rate of perforation was higher in stones with a diameter > or = 1 cm. On the other hand, the migration rate was higher in stones < 1 cm in diameter. Generally speaking, there was no meaningful effect of stone dimension on complication rates.
Tuğcu
Volkan
V
Department of Urology, Bakirköy Training and Research Hospital, Gill D-5 Blok D:35, Bahçeşehir, Istanbul 34538, Turkey. volkantugcu@yahoo.com
Taşci
Ali Ihsan
AI
Ozbek
Emin
E
Aras
Bekir
B
Verim
Levent
L
Gürkan
Levent
L
D000328:Adult; D005260:Female; D006801:Humans; D008096:Lithotripsy; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000601:surgery*; D018666:Ureteroscopy