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Emergency ureteroscopy treatment for distal ureteral stones: endoscopic ureteral aspects and their impact on the success of the endolithotripsy

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Emergency ureteroscopy treatment for distal ureteral stones: endoscopic ureteral aspects and their impact on the

 

success of the endolithotritie.

 

INTRODUCTION AND OBJECTIVES: this study investigates the endoscopic ureteral aspects of emergency

ureteroscopic (URS) in the definitive treatment of distal ureteric stones.

METHODS: In the unicentric and prospective study, which included, from 2008 to 2016, 150 patients treated with

ureteroscopy for acute renal colic was caused by calculi obstruction of the lower urinary tract. They were 68 men and 12 women

with a median age of 43,5 years (20-74years), the visual analog scale (VAS) score was estimated at 6,2. We used a rigid URS 8

CH and lithoclast disintegration device.The parameters studied were : size and location of the stones, macroscopic appearance of

the mucosa and ureteral calculi. Successful treatment was defined as lasting pain relief and complete elimination of stone

fragments.

RESULTS: The average size of the stones was 8,5 mm (range, 6 to 15 mm). Ureteroscopy has visualize the calculi and

appreciate their size in all patients. The site of ureteric stones was pelvic in all cases. The stones were mobile within the ureter in

95% of cases and encrusted in 5% of cases. The ureteral mucosa was the site of a minimal inflammatory reaction (congestion) in

46.6% of cases and Inflammatory beads were uncommon (3,3%). Uretroscopy was conducted in good conditions with a visibility

normal in all patients. The duration of the fragmentation was less than 35 minutes in 90 % of cases. The overall are: stone diameter

(greater than 11 mm); p=0,001, Complications related to the technique were rare. It was minor complications in all cases ( mucosal

injury : 1 case; cracking meatus: 3 cases). No patient experienced a major complication during or after the procedure. The average

length of hospital stay was 1 day in all patients.

CONCLUSIONS: The emergency ureteroscopy, as first line treatment for renal colic related to the distal ureteral stones,

was an effective and safe strategy. They were associated in half of the cases of minimal inflammatory mucosal lesions. Such

lesions they had no impact on the success of the endolithotritie.

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