title: Micro-ureteroscopy: Initial experience in the endoscopic treatment of pelvic ureteral lithiasis.
abstract: OBJECTIVE
  To present to report the first case of ureteral lithiasis resolved using a new endoscopic approach, which we call microureteroscopy (m-URS) and attempts to reduce the ureteral damage caused by conventional instrumentation.
  
  
  METHODS
  We selected a 53-year-old patient with a 16-mm calculus in the right distal ureter. For endoscopic access, we used a 4.8 Fr sheath from the microperc set and fragmented the stone with a 230-micron laser fiber.
  
  
  RESULTS
  Complete fragmentation of the stone was achieved. We placed a JJ catheter due to significant ureteral edema. The surgical time and postsurgical stay were 156minutes and 24hours, respectively. There were no complications, the requirements for analgesia were minimal, and the patient was free of residual stones.
  
  
  CONCLUSIONS
  The m-URS technique is feasible, simple and effective for the treatment of pelvic ureteral lithiasis in women and optimizes minimal invasion, with results that can be comparable to conventional endoscopic techniques in terms of ease of access and quality of endoscopic vision without affecting the resolution capacity. Larger studies and greater technological development is needed to define the definitive role of this procedure. Currently, its major limitations lie in the treatment of proximal ureter lithiasis and in the treatment of men. This technique could also be a viable alternative for pediatric patients.
authors.affiliation: Servicio de Urología, Hospital del Vinalopó, Elche, Alicante, España. Electronic address: juanpablocaballero@gmail.com.
authors.forename: J P
authors.initials: JP
authors.lastname: Caballero
authors.affiliation: Servicio de Urología, Hospital del Vinalopó, Elche, Alicante, España.
authors.forename: J A
authors.initials: JA
authors.lastname: Galán
authors.affiliation: Servicio de Urología, Hospital del Vinalopó, Elche, Alicante, España.
authors.forename: A
authors.initials: A
authors.lastname: Verges
authors.affiliation: Servicio de Urología, Hospital del Vinalopó, Elche, Alicante, España.
authors.forename: A
authors.initials: A
authors.lastname: Amorós
authors.affiliation: Servicio de Urología, Hospital del Vinalopó, Elche, Alicante, España.
authors.forename: A
authors.initials: A
authors.lastname: Garcia-Segui
mesh_terms: D005260:Female; D006801:Humans; D008096:Lithotripsy / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D008904:Miniaturization; D010342:Patient Acceptance of Health Care; D014514:Ureteral Calculi / Q000601:surgery*; D018666:Ureteroscopy / Q000379:methods*; D014546:Urinary Catheterization
keywords: Laser; Lithotripsy; Litiasis urinaria; Litotricia; Láser; Miniaturización; Miniaturization; Ureteroscopia; Ureteroscopy; Urinary lithiasis