Clinical application of tip-flexible semirigid ureterorenoscope for the treatment of impacted upper ureteral calculi

Abstract

Objective To study the clinical efficacy and advantages of tip-flexible semirigid ureterorenoscope combined with Holmium laser lithotripsy for the treatment of impacted upper ureteral calculi. Methods We retrospectively analyzed 75 cases of impacted upper ureteral calculi treated in our hospital between September 2015 and December 2017. There were 45 males and 30 females, aged from 35 to 65 years, mean(42.5±3.5)years. All patients were diagnosed by B-ultrasound and CT with impacted upper ureteral calculi. The mean stone diameter was (1.6±0.3) cm. The CT value of stone was (1 025.3±215.4)HU. Tip-flexible semirigid ureterorenoscope combined with Holmium laser lithotripsy were performed in all of the cases, which were under general anesthesia with lithotomy position, to observe the successful rate of lithotripsy, operation time, intraoperative and postoperative complications, postoperative hospitalization time and stone-free rate. Results All 75 cases were successfully operated. The operation time was (38.5±11.2) min. Three cases had postoperative fever. No severe perioperative complications such as septic shock, ureteral perforation or avulsion occurred. The mean hospital stay of the patients was (2.7±0.4)d. A follow up by non-contrast CT scan was done 4 weeks after the procedure to evaluate the result. Sixty seven cases had stone clearances at the primary operation and the stone clearance rate was 89.3%(67/75). Eight cases undergone ESWL and physical vibration lithecbole, the CT examination showed that the stones were cleared after 1 month. Conclusions Tip-flexible semirigid ureterorenoscope combined with Holmium laser lithotripsy in the treatment of impacted upper ureteral calculi had a definite effect, safe and comfortable for doctors. Key words: Ureteral calculi, upper; Ureteroscope; Holmium laser; Lithotripsy