title: Laparoscopic ureterolithotomy: our experience with 74 cases.
abstract: OBJECTIVE
  We retrospectively evaluated our experience with a relatively uncommon procedure, the laparoscopic ureterolithotomy, for the treatment of ureteral stones.
  
  
  METHODS
  Between April 2002 and October 2006, a total of 74 patients (56 males, 18 females) with upper (54 cases), middle (18 cases) and lower (two cases) ureteral stones underwent laparoscopic ureterolithomy. The mean age was 39.4 years (range, 19-74). The stones were in the right side in 44 cases (59.5%) and in the left side in 30 (40.5%) cases. The mean stone size was 1.8 cm (range 1.5-2.8). The procedure was retroperitoneal in 66 cases (89.2%) and transperitoneal in eight (10.8%) cases. Laparoscopic guided flexible ureterorenoscopic extraction of kidney stone was carried out in one case as an adjuvant procedure. The ureter was stented and not sutured in 64 cases (86.5%).
  
  
  RESULTS
  The procedure was successfully completed in 94.6% of cases and an open conversion was carried out in four (5.4%) patients. The mean operative time was 58.7 min, and the mean blood loss was 90.6 mL. No major complications were encountered. Prolonged urinary leakage occurred in one patient. The mean hospital stay was 6.4 days. One patient developed ureteral stricture during follow up and was treated by endoscopic dilatation and stenting.
  
  
  CONCLUSIONS
  In our experience laparoscopic ureterolithotomy represents a safe and effective treatment option for ureteral stones either as primary for large impacted stones or as a salvage procedure after failed shock wave lithotripsy or ureteroscopy. This procedure fulfills the advantages of minimal blood loss and analgesia requirements, good cosmetic appearance, short hospital stay and convalescence period.
authors.affiliation: Department of Urology, Assiut University, Assiut, Egypt.
authors.forename: Mohamed Gad
authors.initials: MG
authors.lastname: El-Moula
authors.forename: Adel
authors.initials: A
authors.lastname: Abdallah
authors.forename: Fathy
authors.initials: F
authors.lastname: El-Anany
authors.forename: Yaser
authors.initials: Y
authors.lastname: Abdelsalam
authors.forename: Ahmad
authors.initials: A
authors.lastname: Abolyosr
authors.forename: Diaa
authors.initials: D
authors.lastname: Abdelhameed
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Izaki
authors.forename: Abdelmoneim
authors.initials: A
authors.lastname: Elhaggagy
authors.forename: Hiro-Omi
authors.initials: HO
authors.lastname: Kanayama
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014514:Ureteral Calculi / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods; D055815:Young Adult