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

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

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

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

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 transurethral ureteroscopy has been utilized on twenty-two occasions for the treatment of distal ureteral calculi. This resulted in successful stone removal and avoidance of an open operation in 77.3 percent of the cases. The advantages of this type of treatment are that it enables endoscopic access to a surgically difficult portion of the ureter and allows direct visualization during basket manipulation of ureteral calculi. It is concluded that the ureteroscopic stone manipulation could be the first choice of treatment in distalureteral calculi.
Calculi ; Ureter* ; Ureteral Calculi* ; Ureteroscopes ; Ureteroscopy ; Urinary Calculi

Although the rates of tuberculosis cases are continuing decline with advent of newer drugs, sporadic cases of urinary tuberculosis still occur. During last 5 years, we experienced 22 cases of reconstructive surgery and 18 cases of endourologic procedures for preservation of renal function. The following results were obtained: 1. Reconstructive surgeries including ureteroneocystostomy etc. were underwent in 22 cases and improvement were noted in 18 cases. 2. In 18 endourologic cases, there has been a substantial improvement in renal function, decrease in upper tract dilatation and relief of symptom. Average indwelling duration was 2.4 months and the mean number of dilatation per patient was 1.8 time. 3. Endopyelotomy and direct ureterotomy with ureteroscope are useful modalities in multiple ureteral stricture or upper ureter stricture. 4. It should be emphasized that percutaneous antegrade stent indwelling was more easier than retrograde technique especially in failure cases.
Constriction, Pathologic ; Dilatation ; Humans ; Stents ; Tuberculosis ; Tuberculosis, Renal* ; 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

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