Background: Untill now, many minimal invasive methods have been applied in treating ureteral stones such as the endoscopic ureterolithotripsy technique of Perez-Castro and Martinez-Pinero (1980), the tetroperitoneal laparoscopic ureterolithotomy technique of Wickham (1979) and so on. Retrograde endoscopic ureterolithotripsy with holmium laser has been applied in management of ureteral stones at the Post hospital I Hanoi since 2003. Objective: To show results of retrograde endoscopic ureterolithotripsy with holmium laser in management of ureteral stones at the Post hospital I Hanoi. Subjects and method: A retrospective study was conducted in 183 patients who underwent retrograde endoscopic ureterolithotripsy with holmium laser at the Post hospital I Hanoi, from July/2003 to July/2005. Results:In 183 patients, female was more than male (54.7% versus 45.4%); the mean age was 45.4 (range 14-77). There were total 212 lithotrity stones, of which the rate of left, right, upper-third, middle-third and lower-third ureteral stone was respectively 51.9%, 48.1%, 43.2%, 22.4% and 34.4%. The mean size of ureteral stone was 15.1mm x 11.17mm and the average time of ureterolithotripsy was 48.1 minutes (range 15 -120). Conclusion: The rate of success for etrograde endoscopic ureterolithotripsy with holmium laser was high (92.9%), especially the success rate for lower-third ureteral calculi (100%) and the success rate for upper-third ureteral stones (84.8%). However, 5/165 patients (3%) who had follow-up examination for 2-4 years after surgery had ureteral stenosis. This complication was resulted from burned mucous membrane during endoscopic ureterolithotripsy with laser.
Ureterolithiasis/ surgery ; therapy ; Endoscopy/ methods ; Lasers

PURPOSE: Urinary calculi is a familiar disease. A well-known complication of endourological treatment for impacted ureteral stones is the formation of ureteral strictures, which has been reported to occur in 14.2% to 24% of cases. MATERIALS AND METHODS: This was a prospective study. Ureterotripsy treatment was used on patients with impacted ureteral stones. Then, after 3 months and 6 months, the condition of these patients was assessed by means of a kidney-ureter-bladder (KUB) ultrasound. If the KUB ultrasound indicated moderate to serious hydronephrosis, the patient was further assessed by means of a computed tomography intravenous urogram or retrograde pyelogram to confirm the occurrence of ureteral strictures. RESULTS: Of the 77 patients who participated in the study, 5 developed ureteral strictures. Thus, the stricture rate was 7.8%. An analysis of the intraoperative risk factors including perforation of the ureter, damage to the mucous membrane, and residual stone impacted within the ureter mucosa revealed that none of these factors contributed significantly to the formation of the ureteric strictures. The stone-related risk factors that were taken into consideration were stone size, stone impaction site, and duration of impaction. These stone factors also did not contribute significantly to the formation of the ureteral strictures. CONCLUSIONS: This prospective study failed to identify any predictable factors for ureteral stricture formation. It is proposed that all patients undergo a simple postoperative KUB ultrasound screening 3 months after undergoing endoscopic treatment for impacted ureteral stones.
Constriction, Pathologic/*diagnosis ; Humans ; Hydronephrosis/diagnosis ; Kidney/ultrasonography ; Prospective Studies ; Risk Factors ; Ureter/*pathology/ultrasonography ; Ureteral Calculi/*therapy ; Ureterolithiasis/*surgery ; Ureteroscopy/*adverse effects ; Urinary Bladder/ultrasonography