Application of Ureteroscopic Pneumatic Lithortripsy in Patients With Ureter Calculi: Our Five Years Experience

Abstract

Objectives: To evaluate the efficacy and reliability of ureteroscopic pneumatic lithoripsy (URS-PL) in patients with ureter calculi. Methodology: A total of 612 patients who were treated with URS-PL in Medical school of Yuzuncu Yil University, Van State Hospital and Bingol State Hospital in the period between April 2005-May 2010 were studied. Diagnoses of ureter stones were made with intravenous pyelography (IVP) or computerize tomography (CT). Ureteral balloon dilation was not performed on any patient. On the post-operative 1st, 7th and 21st days, control direct urinary system graphic (DUSG) was taken. The rates of stone free and complication were analyzed with the ki-kare test. P < 0.05 was accepted as significant. Results: The mean age of the patients was 39 +/- 10 (18-75). There were 417 males (68.13%) and 195 females (31.86%). The mean volume of calculi in patients was 10.1 +/- 2.3 mm. Of these patients, 121 had proximal ureter stone, 169 medial ureter stones and 322 had distal ureter stones. In the first session of URS-PL, the calculi of 96 patients in proximal ureter (80%), those of 143 patients in medial ureter (85%) and those of 305 patients (95%) in distal ureter were cracked successfully. The mean stone free rate was 92.4% (79.4% in upper ureter, 94.1% in middle ureter and 93.7% in distal ureter (P < 0.05). Overall complication rate was 7.6% (7.7% in distal ureter, 3.9% in middle ureter and 11.8% in proximal ureter) (P>0.05). Most common peroperative complications of the procedure were ureteral perforation 4,2% (n=26), infection 2.2% (n=14), and mucosal laceration 1.9% (n=12). The most common late complication was ureteral stricture in 1.3% (n=8) of patients. Conclusion: Although URS-PL is a commonly used application for the treatment of patients with proximal and middle ureter stones, its common usage could also be extended to patients with distal ureter stones in the first stage of treatment, and it could be considered as an efficient and reliable procedure.