Ureterorenoscopic Lithotripsy; Efficacy and Complications. Is Ureteric Stenting Necessary in Every Patient? | [Annals of the Pakistan Institute of Medical Sciences • 2012]

Author(s):

1. Mumtaz Rasool: Department of Urology and Renal Transplantation, Bahawal Victoria Hospital/Quaid-e-Azam Medical College, Bahawalpur, Pakistan

2. Shafqat Ali Tabassum: Department of Urology and Renal Transplantation, Bahawal Victoria Hospital/Quaid-e-Azam Medical College, Bahawalpur, Pakistan

3. Mudassar Saeed Pansota: Department of Urology and Renal Transplantation, Bahawal Victoria Hospital/Quaid-e-Azam Medical College, Bahawalpur, Pakistan

4. Fariha Mumtaz: Department of Urology and Renal Transplantation, Bahawal Victoria Hospital/Quaid-e-Azam Medical College, Bahawalpur, Pakistan

5. Muhammad Shahzad Saleem: Department of Urology and Renal Transplantation, Bahawal Victoria Hospital/Quaid-e-Azam Medical College, Bahawalpur, Pakistan

Abstract:

Objectives: To observe efficacy and complications of ureterorenoscopic lithotripsy in the treatment of mid and lower ureteric stones. The placement of DJ Stent was also compared for their beneficial role or otherwise. Design of study: Comparative Observational study. Place and Duration of Study: Department of Urology and Renal Transplantation, Quaid-I-Azam Medical College /Bahawal Victoria Hospital, Bahawalpur, from July 2008 to December 2010. Materials and Methods: All adult patients of mid and lower ureteric stones (10-22mm) were included in this study. Initially 107 patients were selected but during procedure 07 patients had proximal stone migration and required extracorporeal shockwave lithotripsy . These patients were excluded along with patients with history of previous ureteric surgery, pyonephrosis and pregnancy. Uretroscopy with Pneumatic Lithotripsy was used. The patients were randomly assigned to two groups, i.e. Group I patients had no DG stent while Group II patients had DJ stent Results: The stone clearance at 24 hours post-operative was 67% in mid ureteric and 73% in lower ureteric stones, at one week 79% and 83%, at one month 87% and 92% and at 3 months 100% stone clearance was seen in both groups. The stented group had more complications and 18% patients of this group had irritative bladder symptoms. Two of these stented patients had severe bladder spasm, steinstrasse and required immediate stent removal at 7th day follow up visit. Conclusion: Ureteroscopic Pneumatic Lithotripsy is best choice treatment for ureteric calculi when patient demands single session removal of stone and alleviation of symptoms. Routine placement of DJ Stent should be discouraged which has more complications as compared to Non-Stented patients. The DJ Stent also requires second procedure for its removal.

Page(s): 161-164

DOI: DOI not available

Published: Journal: Annals of the Pakistan Institute of Medical Sciences, Volume: 8, Issue: 3, Year: 2012

Keywords:

Ureteric calculi , Ureteroscopic Lithotripsy URSL , Double J Stent DJ Stent

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