Ureteroscopy Outcomes, Complications and Management of Perforations in Impacted Ureter Stones
Journal Title: JOURNAL OF UROLOGICAL SURGERY - Year 2016, Vol 3, Issue 4
Abstract
Objective To evaluate ureteroscopy (URS) outcomes and management of perforations in impacted ureteral stones. Materials and Methods We retrospectively evaluated data from 81 patients who had undergone URS for impacted ureteral stones. Per-operative complications were evaluated visually and retrograde ureterography was performed when needed. Injuries of less than 50% around the ureter were classified as minor perforation and greater levels, as major perforation. Perforations were treated by double-j stent or a primary repair with consideration of the perforation grade. Results The stone-free rate was 69% on the first URS attempt and 79% at the end of 3 months. Complications occurred in 34 (42%) patients. Minor perforation occurred in five patients and only double-j insertion was performed at the end of the procedure. Permanent ureteral stricture occurred in four of five patients. Three patients were treated by open ureterolithotomy, fibrotic segment resection and ureteroureterostomy due to major perforations. Transient or permanent ureteral stricture occurred in none of the three patients. The stricture rate was significantly higher in patients who were treated with double-j stent (80% vs. 0% p=0.028) although they had lower perforation rate. Upper location, bigger size (>10 mm) of the ureteral stones and not using smash and go strategy were found to be significant predictors of complications. Conclusion URS for impacted ureteral stone has low success and high complication rates, especially for proximal and big stones. The conservative treatment may fail and result in stricture when perforation is present. Therefore, perforation treatment must be done by fibrotic segment excision and ureteroureterostomy.
Authors and Affiliations
Göksel Bayar, Orhan Tanrıverdi, Kaya Horasanlı, Ayhan Dalkılıç
Keywords
Related Articles
- EP ID EP230549
- DOI 10.4274/jus.971
- Views 77
- Downloads 0
Re: Utilization of Glycosaminoglycans/Proteoglycans as Carriers for Targeted Therapy Delivery
.
An Extremely Rare Kidney Tumor: Primary Intraparenchymal Squamous Cell Carcinoma
Primary squamous cell carcinoma of the renal parenchyma is a rare entity and only 4 cases have been reported in the literature. A 73-year-old female patient presented to our clinic with the complaint of right flank pain....
Re: Rac1-dependent Lamellipodial Motility in Prostate Cancer PC-3 Cells Revealed by Optogenetic Control of Rac1 Activity
.
Parameatal Urethral Cyst: A Case Report
A 17-year-old boy presented with 15 mm swelling on the left side of his urethral meatus. He did not report any voiding symptoms. He was seeking medical treatment due to cosmetic concerns. Parameatal urethral cysts are be...
Enterovesical Herniation: A Rare Complication After Transurethral Resection of Bladder Tumor
Enterovesical herniation through an acquired bladder wall defect after transurethral resection is an exceedingly rare complication. Small bladder perforations may go unrecognized after transurethral resection as adherent...