T. Sović, D. Rako, B. Buj, N. Radović, G. Bedalov, I. Savić, D. Puškar, Z. Peršec
Department of Urology, Clinical Hospital Dubrava
The first ureteroscopy with lithotripsy was performed at our department 1997. We analysed all procedures during 5 years period /2007-2011/. We performed 156 procedures by using Wolf semirigid ureteroscope and Swiss lithoclast.
The stone-free rate of 80.8% /126 out of 156 procedures/ was achived. The procedure had stone-free rate of 56.8% /21 out of 37/, 81.8% /18 out of 22/and 90.5% /86 out of 95/ in upper, mid and lower part of the ureter respectively. The average stone size was 8.3mm /range 4-12/.
A 49 year-old woman underwent ureteroscopy and lithotripsy because of a 12mm stone in the lower part of the right ureter and concomitant signs and simptoms of acute urinary infection.
On the first postoperative day ultrasound and MSCT urography showed mild hydronephrosis. An area of liquid in the right retroperitoneum, with no visible ureteral lesion was found too. The patient was administered antibiotics as well as hyperhidration. Laboratory and kidney ultrasound was checked daily. Liquid in retroperitoneum resorbed sponaneously during next few days.
Unfortunatelly, hydronephosis progressed and a lot of stone particles took place in the ureter. So, the right percutaneous nefrostomy was done.
Patient was released home 7 days following ureteroscopy with normal laboratory. One month later ultrasound and MSCT showed normal right kidney and the right ureter free of stones. Nephrostomy was removed.