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
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.