title: Semirigid ureteroscopy with pneumatic lithotripsy for ureteral stone.
abstract: BACKGROUND
  Ureteral stones present with acute loin to groin pain. The objective of this study is to find out the outcome and safety of semi-rigid ureterscopy with pneumatic lithotripsy for treatment of ureteral stones of >30 mm(2) and to assess the impact of size and location on stone free (SF) rate.
  
  
  METHODS
  Total 110 patients with isolated ureteral stone size>30 mm(2) were included in this study and treated with pneumatic lithotripsy using 8/9.8 Fr. Semi-rigid ureteroscope (Stiema Germany). Stones were fragmented into 2-3 mm particles and removed. Outcome parameters assessed at 3 months follow up were stone free rate(SF),Efficiency Quotient (EQ), and impact of stone size and site on SF/EQ was also analyzed. Similarly, patient demographics, procedures, patient related parameters and complications were also noted.
  
  
  RESULTS
  The overall SF rate at 3 months follow up was 69.33% and efficient Quotient (EQ) 52.52%. The SF/EQ for upper, middle and lower third of ureteral stone was 55/37.67, 61/43.57, 92/84.40 respectively (P-value< 0.001). The SF for stone size 30-110 mm(2) and >110 mm(2) was 78% and 67% respectively. There were no major complications seen. Overall minor complication rate was 5.45 % (minor ureteral perforations-5, urinoma formation 1).
  
  
  CONCLUSIONS
  Semi-rigid ureteroscopy with pneumatic lithotripsy is a safe, simple and effective procedure for ureteral stones with excellent success rate for distal ureteral stones. The stone free rate and EQ are statistically significant (P value<0.001) between upper, middle and lower ureteral stones. Stone size has a direct impact on the SF rate and EQ.
authors.affiliation: Department of Surgery, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal. udayadongol@yahoo.com
authors.forename: U Ms
authors.initials: UM
authors.lastname: Dongol
authors.forename: L
authors.initials: L
authors.lastname: Acharya
authors.forename: K
authors.initials: K
authors.lastname: Subba
authors.forename: B
authors.initials: B
authors.lastname: Khambu
authors.forename: R
authors.initials: R
authors.lastname: Joshi
authors.forename: S K
authors.initials: SK
authors.lastname: Shrestha
authors.forename: D R
authors.initials: DR
authors.lastname: Singh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000601:surgery*; D020709:Ureteroscopes; D018666:Ureteroscopy / Q000379:methods*; D055815:Young Adult