Is it mandatory to use a guidewire and to collect the stone fragments in lower ureteral calculi?
Department of Urology, Sema Hospital, İstanbul
Department of Urology, Faculty of Medicine, Rize University, Rize
Clinic of Urology, Antalya Training and Research Hospital, Antalya
Department of Urology, Sema Hospital, İstanbul, Turkey
Turkish J Urology 2011; 37: 303-306
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Key Words: Lithotripsy; safety; ureteral calculi; ureteroscopy.
Objective: This prospective clinical study compared two different ureteroscopic lithotripsy methods for treating lower ureteral stones.
Materials and methods: Ureteroscopic lithotripsy was applied in 110 patients with lower ureteral stones between February 2007 and April 2011. The stones were fragmented with a pneumatic lithotripter. In Group 1 (n=55), ureteroscopic lithotripsy was performed without a guidewire and the stone fragments were not collected. In Group 2 (n=55), a ureteral guidewire was used and the stone fragments were collected with a basket catheter or forceps. The two groups were compared in terms of operating time, stone free rates, renal colic, and complications.
Results: The mean operating time was 17 min (range 12-30 min) and 35 min (range 25-95 min) for Groups 1 and 2, respectively. Macroscopic hematuria was recorded in 3 patients in Group 1 for 30 hours compared to 8 patients for 48 hours in Group 2. Mild or moderate renal colic was observed in 9 patients in Group 1 and recurred 1-11 times versus only 4 cases in Group 2 (p<0.05). The patients were re-examined 20 days postoperatively, and no residual stone, urinary obstruction, hematuria or pain was observed in either group.
Conclusion: For endoscopic treatment of lower ureteral stones, ureteroscopic lithotripsy without a guidewire and collection of the fragmented stones is safe for experienced urologists.