Mihály Zoltán Attila, Mănescu Mihai Răzvan, Călin Neiculescu, Mihály Orsolya, Victor Ona and Coman Ioan
Urology Department, Clinical Municipal Hospital, Cluj-Napoca, Romania.
PURPOSE: The development of semirigid ureteroscopes has permitted a safe and an easier access to calculi througout the urinary tract. The objective of the study was to investigate the safety and efficacy of semirigid ureteroscopy and holmium laser lithotripsy for the management of patients with uretheral stones
MATERIALS AND METHODS: Ureteroscopic stone treatment was attempted in 114 patients with isolated and multiple urethral stones between November 2008 and January 2012. Semirigid ureteroscopy was performed in all patients under spinal anesthesia, and they were then treated with the Holmium-Versapulse laser. Patients were monitored before the hospital discharge with abdominal radiograph and ultrasonography, which were also performed at 3 months after surgery. Preoperative, operative and post operative data were retrospectively analyzed.
RESULTS: Mean stone size was 6.8 mm We obtained a complete immediate fragmentation of stones in 74% of the patients, A proximal migration of stones was observed in 9% of the patients. The mean operative times was 55,35 minutes. There were 5 patients who underwent a second ureteroscopy.There were no .uretheral perforation after laser treatment and no patient developed urosepsis. Complications occurred in 2 procedures flank pain and stent pain . No patient died.
Semirigid ureteroscopy with Holmium-Versapulse laser is a safe and effective tehnique in management of uretheral stones with a low rate of postoperatory complications.