U J All Final for WEB.pdf 807Vol. 10 | No. 1 | Winter 2013 |U R O LO G Y J O U R N A L A Novel Technique for Treatment of Distal Ureteral Calculi Early Results Bayram Guner,1 Cenk Gurbuz,2 Turhan Caskurlu2 Keywords: ureter, calculi, ureteral calculi, ureteroscopy INTRODUCTION M(SWL) and ureteroscopy are commonly used treatment modalities for removal of distal ureteral stones. Analysis of the literature for the past 3 years indicates Especially, improvements in the design and accessories of ureteroscopes have led to increase in success rates. - teral stones. Corresponding Author: Bayram Guner, MD Department of Urology, State Hospi- tal, Mus, Turkey Tel: +90 532 582 9016 Fax: +90 216 570 9165 E-mail: gunerbayram@yahoo.com Received November 2011 Accepted October 2012 1 Department of Urology, Mus State Hospital, Mus, Turkey 2 Department of Urology, Istanbul Goztepe Research and Training Hospital, Istanbul, Turkey POINT OF TECHNIQUE 808 | Point Of Technique CASE REPORT - orenoscopy to treat ureteral stones at the Department of Urology of Clinical Hospital Center of Goztepe and Mus - LithoClast, Electro Medical Systems). - - - - informed consent pre-operatively. Thereafter, all of them period. Voiding cystourethrography (VCUG) or cystoscopy (A) Showing intramural ureteral calculi; (B & C) Radiofrequency incision of superior wall of the intramural ureter; (D) Extraction of calculi with endoscopic grasper. 809Vol. 10 | No. 1 | Winter 2013 |U R O LO G Y J O U R N A L Radiofrequency Energy in Intramural Ureteral Stones | Guner et al TECHNIQUE - only for impacted ureteral calculi localized intramurally in - ergy. After the stone had been reproduced into the bladder, - st - - - - the patients had urinary tract infection and hydronephrosis peri-operatively. - - rd postop- - DISCUSSION - - - ser, and basket catheter. Stone size, composition, and localization, hydronephrosis, symptoms, anatomic variation, infection, duration of the - ment, and SWL are contributory factors for selection of ureteral calculi treatment. The stone-free rate of semi-rig- ureteral calculi can have impairment of the kidney func- tion at presentation. In our study, all of the patients had hydronephrosis, and the average time of diagnosis to treat- st post- - plication. - Patients characteristic. Variables Median (range) Age, y 52.1 (31 to 80) Stone size, mm 12.4 (10 to 16) Hydronephrosis, grade 2 (1 to 3) Operation time, min 18 (12 to 24) Hospitalization, day 1.1 (1 to 3) Follow-up, month 16.7 (11 to 21) 810 | - CONFLICT OF INTEREST None declared. REFERENCES 1. Knispel HH, Klan R, Heicappell R, Miller K. Pneumatic lithotripsy applied through deflected working channel of miniureteroscope: results in 143 patients. J Endourol. 1998;12:513-5. 2. Osti AH, Hofmockel G, Frohmuller H. Ureteroscopic treat- ment of ureteral stones: only an auxiliary measure of extra- corporeal shockwave lithotripsy or a primary therapeutic option? Urol Int. 1997;59:177-81. 3. du Fosse W, Billiet I, Mattelaer J. Ureteroscopic treatment of ureteric lithiasis. Analysis of 354 urs procedures in a com- munity hospital. Acta Urol Belg. 1998;66:33-40. 4. Harmon WJ, Sershon PD, Blute ML, Patterson DE, Segura JW. Ureteroscopy: current practice and long-term compli- cations. J Urol. 1997;157:28-32. 5. Tiselius HG, Ackermann D, Alken P, Buck C, Conort P, Gal- lucci M. Guidelines on urolithiasis. Eur Urol. 2001;40:362-71. 6. Erhard M, Salwen J, Bagley DH. Ureteroscopic removal of mid and proximal ureteral calculi. J Urol. 1996;155:38-42. 7. Wu CF, Shee JJ, Lin WY, Lin CL, Chen CS. Comparison between extracorporeal shock wave lithotripsy and semirigid ureterorenoscope with holmium:YAG laser lithotripsy for treating large proximal ureteral stones. J Urol. 2004;172:1899-902. 8. Hendrikx AJ, Strijbos WE, de Knijff DW, Kums JJ, Doesburg WH, Lemmens WA. Treatment for extended-mid and distal ureteral stones: SWL or ureteroscopy? Results of a multi- center study. J Endourol. 1999;13:727-33. 9. Vaughan ED, Jr., Gillenwater JY. Recovery following com- plete chronic unilateral ureteral occlusion: functional, radi- ographic and pathologic alterations. J Urol. 1971;106:27-35. 10. Irving SO, Calleja R, Lee F, Bullock KN, Wraight P, Doble A. Is the conservative management of ureteric calculi of > 4 mm safe? BJU Int. 2000;85:637-40. Point Of Technique