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

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

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

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

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

The study was designed to evaluate the radiological and pathological changes in the periureterally extravasated left ureter of rabbit following the irrigation with normal saline without dilatation and the effects of steroid in 30 rabbits. The rabbits were divided into two groups :the periureterally extravasated group without steroid administration( irrigation group) and the steroid administered group before and after ureteral irrigation( irrigation + steroid group). The results were as follows: 1. The frequency of ureteral peristalsis was decreased in both irrigation group and irrigation steroid group compared to the that of pre-irrigated one but with no significant difference between two groups. 2. The ureteric wall was easily liable to hydrostatic inflammatory reactions even with only periureteral extravasation in both irrigation group and irrigation +steroid group but with no significant difference between two groups. 3. The mechanism for the ureteral and periureteral fibrosis at an area where ureteroscope hasn't contacted is thought to be related to the microscopic or visible injury of transitional epithelium of ureter followed by extensive mucosal or periureteral extravasation of irrigation fluid resulted from high pressure of the irrigant within the ureteral lumen.
Dilatation ; Epithelium ; Fibrosis ; Peristalsis ; Rabbits ; Ureter* ; 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