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

PURPOSE: Shockwave lithotripsy(SWL) and ureteroscopic manipulation became the standard treatments for ureteral stones in recent years. There still exists significant debate as to the most appropriate treatment modality for ureteral stone management. MATERIALS AND METHODS: From January 1994 to December 1995, 651 patients of ureteral stones were treated and 589 patients were retrospectively reviewed excluding 62 patients for incomplete follow ups. Four hundred and forty-two patients were treated with SWL using MPL 9000 with ultrasonic guidance, 115 patients with ureteroscopic manipulation using 7.9 to 11.5Fr rigid and semirigid ureteroscopes. RESULTS: In SWL treatments, overall stone free rate was 74.7% with one session, Stone free rate was significantly affected by the size of stones. Stone free rate was 83.6% when the stone was smaller than 1.0cm and 42.1% when the stone was larger than 1.0cm Stone free rate after second SWL session was 84.4% and 90.3% after third session. The stone free rates according to the site of stones were 72.4(proximal), 70.0(mid), 80.2(distal), respectively. In ureteroscopic manipulation, overall stone free rate of 87.8% was obtained regardless of the size of stones. The success rates according to the location of stones were 75.0(proximal), 94.6(mid), 86.4%(distal), respectively. Open ureterolithotomy was performed in 32 patients with 100% success rate. CONCLUSIONS: In our study, the size of stones was the most important factor influencing the success rate of SWL treatment for ureteral stones. We consider ureteroscopic manipulation as the first line treatment modality when the stone is larger than 1.0cm, especially in distal ureter, Proper selection of patients for in situ SWL or ureteroscopy would improve the results of initial treatment.
Follow-Up Studies ; Humans ; Retrospective Studies ; Ultrasonics ; Ureter* ; Ureteroscopes ; Ureteroscopy

PURPOSE: This study examined the efficacy of ureteroscopic stone manipulation with comparing the success rates and complications rates. MATERIALS AND METHODS: The manipulation of calculi can be done under the direct vision of ureteroscope using dormia baskets with increasing safety and efficacy. The results of ureteroscopic removal of stones were reviewed in 636 cases. From January 1992 to October 1997, 636 patients underwent ureteroscopic removal of stones. RESULTS: There were 236 female and 400 male patients between 16 and 75 years old. The success rates of ureteroscopic removal of stones were related to location of the calculus: 95.8% in lower ureter, 87.7% in mid ureter and 90% in upper ureter(overall success rate was 95%). 35 cases(5.8%) of complication occurred in 604 cases of success: Severe ureteral mucosal injury in 25 patients, gross hematuria(>48hours) in 4 patients, ureteral mucosal prolapse in 3 patients, flank pain(>48hours) in 2 patients, ureteral perforation in 1 patient. CONCLUSIONS: Ureteroscopic removal of stones can be successful and safe treatment modality for lower urethral stones, especially with plentiful experience and good surgical skill.
Aged ; Calculi ; Female ; Humans ; Male ; Prolapse ; Ureter ; Ureteroscopes ; Ureteroscopy

PURPOSE: There still exists controversy as to the most appropriate treatment modality for lower ureteral stone; ureteroscopic removal of stone (URS) versus shockwave lithotripsy (SWL). So we compared clinical results of both procedures to help determine which is more appropriate as initial management for lower ureteral stones. MATERIALS AND METHODS: We retrospectively reviewed 587 patients who had been treated for their lower ureteral stones at our institute. 184 patients were treated under the direct vision of ureteroscope using stone basket or Lithoclast and 403 patients were treated by SWL. We analyzed success rates and complication rates of each procedure. RESULTS: Overall stone free rates were 95.7% with URS and 84.6% with SWL. In SWL group, stone free rate after third session was 88.3% when the stone was smaller than 10mm and 74.0% when the stone was larger than 10mm. But in URS group, the size of stones did not affect to stone free rate. And impaction of stone affected stone free rate. Stone free rates of impacted ureteral stones were 95.2% with URS and 63.8% with SWL. The complications of URS were found in 8.7% but all of them were successfully treated with ureteral stenting for 3 weeks or conservative treatment. While complications in SWL group were minimal. CONCLUSIONS: In our study, URS and SWL were successful and safe treatment modality for lower ureteral stones. And we consider URS as the first line treatment modality when the stone is larger than 10mm or impacted.
Humans ; Lithotripsy* ; Retrospective Studies ; Stents ; Ureter* ; Ureteroscopes ; Ureteroscopy

Rigid ureteroscopic treatment of ureteral calculi can be highly successful and result in lower morbidity. Manipulation of calculi can be done under direct vision using grasping forceps of stone baskets with increasing safety and efficacy. Between June 1986 and August 1987, 34 ureteroscopies were performed for the removal of ureteral stones in this urologic department. In 30 cases(88.2%), the stone was removed successfully. In lower ureteral stones, ureteroscopy has been used successfully to remove the stone in 28 of 31 cases(90.3%). Except for the ureteral perforation in one case, all complications have been minimal and resolved spontaneously.
Calculi ; Hand Strength ; Surgical Instruments ; Ureter* ; Ureteral Calculi* ; Ureteroscopes* ; Ureteroscopy