Abdul Majid Rana.
Comparison of results of Ureteroscopy for proximal and distal ureteral calculi using rigid Ureteroscope.
Med Channel Jan ;11(2):58-60.

OBJECTIVE: To evaluate success rate of ureteral calculi treated in proximal and distal ureter using rigid ureteroscope. MATERIAL AND METHODS: Ureteroscopic treatment of ureteral calculi was attempted in 411 Patients using Pneumatic lithoclast as only tool for stone fragmentation during /996 to December 2004. Requirement of additional procedure other than ureteroscopy to treat the stone and inability to access the stone by ureteroscope were considered as failure. RESULTS: Out of 411 patients 346 (84.1%) patients were cleared of stones after single endoscopic procedure. 14 patients with proximal stones (n=10) and distal (n=4) required more than one endoscopic measures to make them stone free. 5I patients with Proximal stones (n=35) (8.5%) and distal stones (n=16) (3.8%) failed ureteroscopic management of calculi. Overall success rate of 87.6% with success rate of 8I.7% in proximal ureter and 92.7% in distal ureter was achieved-indicating proximal ureteral stones being associated with higher treatment failure. Incidence of intra operative and early Postoperative complications were low and management was mostly conservative. CONCLUSION: Ureteroscopic management of ureteral calculi is highly successful along its entire course, although proximal ureteral stones are more prone to treatment failure as compared to distal ureteral stones. Increased accessibility to flexible scopes and flexible fragmentation devices should further narrow down the success rate substantially.

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