Ureteroscopic stone extraction is popular method for the management of ureteral stone after innovative development of rigid ureteroscope. A sequential analysis of the clinical study revealed that during the first 39 cases success rate was 56.4 %. Within the latter 39 cases success rate was 92.3%. Complication included ureteral perforation in 2 cases (2.7% ), fever more than 38 degrees C in 2 (2.7%). Although E.S.W.L. is the mainstream of method of management for ureteral stone, ureteroscopic stone extraction is choice for urologist where E.S.W.L. is not available or when patient refuses E.S.W.L.
Fever ; Humans ; Ureter ; Ureteroscopes

: In the field of Urology, flexible ureterorenoscopy (fURS) remains a challenging skill for junior residents to develop due to its steep learning curve. Hence, training models were incorporated into simulation-based training to allow for novice trainees to overcome the learning curve without potentially compromising patient outcomes and minimize complications. OBJECTIVE: To describe the design and test the validity of a non-biological three-dimensional (3D) model of the pelvocalyceal system as a tool for simulation-based training for flexible ureterorenoscopy. METHODS: This was a prospective, quasi-experimental, surgical innovation research stage 2a study conducted in a tertiary government hospital. The retrograde intrarenal surgery (RIRS) box was composed of four siliconized pelvocalyceal systems which were 3D printed using computed tomography urograms of actual patients. Thirty-two urologists were asked to perform flexible ureteroscopy using the RIRS box and were given a questionnaire to assess face and content validity using the Likert scale. RESULTS: The RIRS Box training model showed good face and content validity. The 3D printed pelvocalyceal system was judged to have a close anatomical resemblance to an actual calyceal system. While performing fURS, the RIRS box provided similar pelvocalyceal visualization and instrument handling as in an actual procedure. Majority of participants considered the training model useful for training (75%) and believed that it may improve the RIRS technique (46.8%). CONCLUSION The RIRS Box training model may help urologists improve the manner in which they acquire technical knowledge and skills necessary in performing fURS.
Ureteroscopy ; Ureteroscopes ; Printing, Three-Dimensional

Since January 1988 a group of 54 patients presenting with stone in the lower third of the ureter have been treated with rigid ureteroscope. In 47 cases(87 per cent) the stone was removed successfully. The associated number of complication was low, with most patients being treated conservatively. Our results confirm the safety and efficiency of ureteroscopy to manage the lower ureteral stones.
Humans ; Ureter* ; Ureteral Calculi* ; Ureteroscopes* ; Ureteroscopy

Rigid ureteroscopy is now established technique for the management of ureteral stones. We evaluated the experiences of rigid ureteroscopy retrospectively at our institutions from October 1990 to June 1991, 30 ureteroscopies were performed for the removal of ureteral stones and one ureteroscopy for the removal of Kock pouch stones. In 23 cases(74.2%), the stones were removed successfully. The likelihood of failure was greater for stones larger than 10mm and above the lower ureter. Among the reasons for failure to remove stones. the failure to insert the ureteroscope into the ureteral orifice was the most common. Complications were developed in 11 cases but managed conservatively in all cases. We agree that ureteroscopic removal of stone is the treatment of choice for lower ureteral stone of smaller than 10mm in size with proven efficacy and safety.
Colonic Pouches ; Retrospective Studies ; Ureter ; Ureteroscopes ; Ureteroscopy

To define indications of primary treatment in ureteroscopic stone manipulation with comparing the success rates and complications of A(11.5F rigid ureteroscopy from March 1989 to April 1993) and B(7.5F rigid ureteroscopy from May 1993 to February 1995) groups, 216 ureteroscopies were performed for ureteral stone removal between March 1989 and February 1995 in our urologic department. The overall success rates of ureteroscopic stone manipulation were obtained and compared according to stone locations, sizes and anesthesia or not. The overall success rate was 85.6%(80% in group A and 94.2% in group B respectively). The success rates in each group A and B were 60% and 77.8% in the upper ureter, 100% and 66.7% in the middle ureter, 80.0% and 95.9% in the lower ureter. There were the more success rates and the less complication rates in group B than group A. The success rates of stone removal are increased and the complications are decreased remarkably in group B(especially in the lower ureter stone). The rapid relief of ureteral obstruction and colic is possible immediately after ureteroscopic stone manipulation. So, we conclude that ureteroscopic stone manipulation is primarily indicated in the treatment of lower ureteral stones.
Anesthesia ; Colic ; Ureter ; Ureteral Obstruction ; Ureteroscopes ; Ureteroscopy

Ureteroscopy is the newer procedure for the treatment of ureteral calculi, and now established the first treatment of ureteral calculi. A study of 42 cases of ureteroscopic removal of stones was performed. Removal of stones was successful in 29 of 42 attempts(69 percent). 26 of 31 patients with lower ureteral calculi (84 percent) and 26 of 35 patients with calculi smaller than 1 cm(74 percent) underwent successful removal. There were no significant complications during or after the procedure. In conclusion, ureteroscopic removal of stones can be the first choice of treatment of ureteral calculi, and proper technique, surgical skill and prudence are essential prerequisites and increase experience will improve the success rate.
Calculi ; Humans ; Ureteral Calculi ; Ureteroscopes ; Ureteroscopy

We evaluated the availability of Lithoclast in ureteroscopic removal of stone retrospectively. We treated 62 patients(68cases) with ureteral calculi using stone basket or Swiss Lithoclast lithotriptor with the rigid ureteroscope (URS) between December 1993 and February 1995. The success rates of URS were 93%(63/68), and Lithoclast use rates were 77%(52/68). According to stone site, Lithoclast use rates were 68%(28/41) in the lower ureter, 86%(12/14) in the mid, 92%(12/13) in upper ureter respectively. According to stone size, Lithoclast use rates were 50%(4/8) in less than 0.5cm, 75%(30/40) in 0.6-1.0cm, 89%(16/18) in 1.1-2.0cm, 100%(2/2) in above 2.0cm respectively The Lithoclast successfully fragmented stones. There were 5 failures of URS due to failure in access to stone by URS(4 cases), impacted stone(1 case). Reoperation consist of URS in 2 cases, ureterolithotomy in 2 cases and nephrectomy in 1 case. The complications of Lithoclast use URS were insignificant such as gross hematuria(3 cases), infection(2 cases), flank pain(1 case). There were no intraoperative or long term complications directly related to the use of this device. In conclusion, Swiss lithoclast lithotripsy significantly contributed to improve the success rates in treatment of ureteral stone, and is a safe, effective and inexpensive device.
Lithotripsy ; Nephrectomy ; Reoperation ; Retrospective Studies ; Ureter ; Ureteral Calculi ; Ureteroscopes

Rigid ureteroscopic removal of ureteral calculi is an established treatment nowadays and can be performed under direct vision using flexible grasping forceps, stone baskets, ultrasonic lithotriptor or electrohydraulic lithotriptor with increased safety and efficacy. Between May 1988 and May 1989, 38 cases of ureteroscopic removal of stone were performed in our urologic department. Twenty eight among 36 cases of lower ureteral stone and none among the 2 cases of mid ureteral stone were removed successfully with the overall success rate of 73.7 % (28 among 38 cases). There noted no difference in the success rate from the stone size. Among the reasons for failure to remove ureteral stone, the failure to insert the ureteroscope into the ureteral orifice due to mucosal injury during ureteral dilation was the most commonly encountered problem. Complications occurred in 8 cases but no surgical intervention was needed in all cases. We agree that rigid ureteroscopic removal of stone under direct vision is the first line of treatment for lower ureteral calculi with proven efficacy and safety.
Hand Strength ; Surgical Instruments ; Ultrasonics ; Ureter ; Ureteral Calculi ; Ureteroscopes

Percutaneous Endopyelotomy is a natural outgrowth of technique developed for percutaneous ureteral and renal stone removal. In it`s comparison to the Davis ureterotomy technique, a rationale for this procedure and explanation for it`s success is provided. Endopyelotomy, which we performed experimentally to prevent recurrent stone formation, has now matured into a viable procedure under the certain guideline. This procedure has become our first choice for secondary ureteropelvic junction obstruction but primary cases were not experienced. Although classical pyeloplasty must be main surgical means to UPJ obstruction, technical and equipmental advanced could be enabled us to perform 8 endopyelotomy. We incised UPJ obstruction in 8 cases with direct vision nephroscope inserted through a percutaneous nephrostomy tract and ureteroscope. In 6 patients, renal calculi were removed endourologically during same and separate session. There were no immediate complication and nephrostogram showed adequate drainage in all cases.
Drainage ; Humans ; Kidney Calculi ; Nephrostomy, Percutaneous ; Ureter ; Ureteroscopes

Between august 1986 and march 1988, 75 transurethral ureteroscopic lithotripsies were performed in 65 patients with 69 ureters. Analyzed sequentially, removal was successful in 40.6 per cent among the initial 30 patients(32 ureters) and in 81.1 percent among the subsequent 35 patients(37 ureters). The overall success rate was 62.3 percent. The common causes of failure were; Upward migration of stone, difficult ureteroscopic maneuvers to retch calculi, failure of ureteroscopic insertion in order. Of complications, 3 cases of ureteral perforation and 2 cases of ureteral avulsion were most severe. In one case who has circumferential denudation of ureteral mucosa with no urine flow in ureter, the ureteral orifice was noted with marded adhesion and total obstruction. To prevent this kind of complication, ureteral stenting is thought to be indicated. Even in the case of successful transurethral ureteroscopic lithotripsy without any immediated complications, the long-term follow-up will be necessary to detect late complications such as disturbance of peristalsis or VUR due to the fibrotic changes of ureter resulted from the insertion of ureteroscope.
Calculi ; Humans ; Lithotripsy* ; Mucous Membrane ; Peristalsis ; Stents ; Ureter ; Ureteroscopes