INTRODUCTION: The purpose of the study was to determine the safety and efficacy of one-stage ureteroscopy for treatment of bilateral ureteric stones.
METHODS: Retrospective data were obtained from the patient database in the Department of Urology at Minia University Hospital between March 2008 and November 2010. There were 34 patients (20 men and 14 women) with a mean age of 38.4 years (SD = 13.6; range,16-82 years). All patients underwent one-stage ureteroscopy for bilateral ureteric stones using an 8 Fr semirigid ureteroscope. A 0.038 inch floppy-tipped guidewire was passed through the selected ureteric orifice, advanced under direct vision, and monitored fluoroscopically. Balloon dilation of the intramural ureter was completed in most cases. Stone treatment was chosen according to its size and occurred by direct extraction or lithotripsy using the pneumatic lithoclast. Postoperatively, unilateral or bilateral ureteral stenting was done for 2 days to 6 weeks. Patients were followed for a minimum of 3 months.
RESULTS: Sixty four ureteroscopic procedures were successfully completed to treat 32 of the 34 patients. Mean stone size was 8.3 mm (range, 3-20 mm). The stones were radio-opaque in 28 patients and dense in 4 patients. A single stone was found in 30 patients (93.75%); 2 patients had multiple stones. Calculi were retrieved intact using baskets for 18 patients; lithotripsy was required for 14. The mean operative time was 85 minutes (range, 35-150 minutes). Intraoperatively, 25 of 32 patients (78.2%) were stone-free bilaterally and another 7 patients (21.8%) were stone-free unilaterally. Thirty patients (93.7%) were stone free 1-month after 1 endoscopic procedure; 2 patients were clear after 2 procedures. Early postoperative complications were rare and included fever in 4 patients; no long-term complications were observed.
CONCLUSION: One-stage ureteroscopy for bilateral ureteric stones is a safe and effective procedure that can achieve stone-free and complication rates that are comparable to those of unilateral ureteroscopy.
Ehab Mohamad Galal, Tarek Khalaf, Fath El-Bab
Submitted: April 8, 2011
Accepted for Publication: April 28, 2011
KEYWORDS: One-stage ureteroscopy; Bilateral ureteric stones
CORRESPONDENCE: Ehab Mohamad Galal, MD, Urology Department, Minia University Hospital, Minia City, Egypt( ).
CITATION: UroToday Int J. 2011 Aug;4(4):art45
doi:10.3834/uij.1944-5784.2011.08.01