A 10‐year experience of managing ureteric calculi: changing trends towards endourological intervention—is there a role for open surgery?

Ather, M Hammad; Paryani, Jai Pal; Memon, Amanullah; Sulaiman, Muhammad

doi:10.1046/j.1464-410x.2001.02302.x

Cited by 62 publications

(51 citation statements)

References 12 publications

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“…The debate on the current indications for OSS continues; Ather et al [4] included anatomical abnormalities, failure of the first-line treatment, patient preference, an impacted large stone, and a concomitant open procedure to be appropriate indications. Until the late 1990s, we used MAU as the first-line treatment for all ureteric stones that did not pass spontaneously.…”

Section: Discussionmentioning

confidence: 99%

Open mini‐access ureterolithotomy: the treatment of choice for the refractory ureteric stone?

2003

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RESULTSMAU was successful in 111 patients; the one failure was caused by proximal stone migration early in the series. The mean (range) operative duration was 28 (10-44) min and the hospital stay 42 (24-72) h; 33 patients were in hospital for 24 h, 72 for 48 h and seven for 72 h. The blood loss was minimal, at 50 (30-150) mL. The drain was removed after 5 (5-7) days. Patients reported using opioid or nonsteroidal anti-inflammatory analgesia for a mean of 4 (1-7) days after surgery. The mean time to resumption of work was 16 (8-35) days. CONCLUSIONSMAU is a safe and reliable minimally invasive procedure; its role is mainly confined to salvage for failed first-line stone treatments but in selected cases, where a poor outcome can be predicted from other methods, it is an excellent first-line treatment. KEYWORDS mini-access, ureterolithotomy, technique, complications, indications, surgeon OBJECTIVETo report the experience in one centre of the efficacy and safety of open mini-access ureterolithotomy (MAU) and to discuss relevant current indications. PATIENTS AND METHODSMAU was undertaken in 112 patients (mean age 38 years, range 26-57) between 1991 and 2001; the details and outcomes are reviewed. The mean (range) stone size was 12 (8-22) mm, with 30 stones in the upper, 69 in the mid-and 13 in the lower ureter. In 15 cases the stones were impacted and there were signs of infection in the proximal ureter.

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Section: Discussionmentioning

confidence: 99%

Open mini‐access ureterolithotomy: the treatment of choice for the refractory ureteric stone?

2003

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“…The complication rates per urologist range from 0% to 14.8%, this is within accepted limits. 10,13,15 However, it is interesting to note that the surgeon who performed the highest number of procedures (153) complication rate of 14.8%. A possible explanation for this may be that the Urologist concerned, being more experienced, took on the more difficult cases that were liable to result in higher complication rates.…”

Section: Discussionmentioning

confidence: 99%

“…6 Extracorporeal shockwave lithotripsy is very effective in treating many ureteral stones without the potential morbidity associated with ureteroscopy. 10,11 Ureteroscopy is, therefore, reserved primarily for those patients in whom primary extracorporeal shockwave lithotripsy has failed or in those patients in whom extracorporeal shockwave lithotripsy is contraindicated. 10,12 The indications for open and laparoscopic ureterolithotomy has diminished with time because of effective therapeutic options like extracorporeal shockwave lithotripsy and ureteroscopy.…”

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confidence: 99%

Morbidity associated with surgical treatment of ureteric calculi in a teaching hospital in Kuwait

Kehinde

Al-Awadi

Al-Hunayan

et al. 2003

ann r coll surg engl

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Background: Ureteric lithiasis is a common urological problem in Kuwait. Because of the different interventional approaches, we carried out an audit on the morbidity associated with the surgical management of the disorder. Patients and Methods:The surgical records were reviewed of all patients with the diagnosis of ureteric lithiasis that were managed surgically by ureteroscopy or ureterolithotomy in Mubarak AlKabeer Hospital in Kuwait between January 1996 and December 1999. Patients' bio-data, location of calculi, indications for surgical intervention, types of therapeutic interventions, operating surgeon and complications were analysed. Patients managed primarily and successfully by extracorporeal shockwave lithotripsy were excluded from this analysis. Results: A total of 1383 patients with ureteric calculus were managed in the period under review -775 (56%), 567 (41%), and 41 (3%) patients were managed by extracorporeal shockwave lithotripsy, ureteroscopy and ureterolithotomy, respectively. The 608 patients managed by ureteroscopy or ureterolithotomy had a total of 710 operations. The commonest surgical procedure performed was ureteroscopy with Dormia basket with or without double 'J' stenting and this accounted for 418 (58.9%) operations. The least common procedure was ureteric meatotomy with Dormia basket and with or without double 'J' stenting in 9 (1.3%) patients. The overall complication rate was 110 out of 710 (15.5%) operations. Of the complications, 101 (92%) were minor ( e.g. haematuria, fever, and mucosal injury). Nine (8%) complications were major complications ( e.g. ureteric perforation and ureteric avulsions). Ureterolithotomy and ureteroscopy with intracorporeal lithotripsy were associated with the highest complication rates. Conclusions: This analysis has shown that with technological advances, the treatment of ureteric lithiasis has improved and major complications have decreased. However, with so many therapeutic options to choose from, there is a need to audit the various therapeutic options and select those associated with the least morbidity rates in each urology unit.

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“…Ureteroscopy has become as effective as open surgery with little attendant morbidity. 7 Early intervention and relief of an obstruction preclude the development of renal obstructive complications. Also with modern lifestyles and demands of the place, the patients prefer rapid diagnosis and early management of their problem.…”

Section: Success Ratementioning

confidence: 99%

Ureteroscopy for management of ureteric calculi: Five years experience in Erbil, Iraq

Bazzaz¹,

Toma

2017

ZJMS

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Background and objective:Retrograde ureteroscope has recently gained a broaden indication for use in from diagnostic to a variety of disorders that occur in the upper urinary tract. This study aimed to review our five years experience with ureteroscopic management for ureteral stones and to compare our rates of efficacy and safety of ureteroscopy with other centers. Methods: Review of 736 consecutive patients who underwent ureteroscopic procedures for the treatment of upper urinary tract problems between January 2010 and January 2015 was done in Erbil, Iraq. Out of those patients, 587 patients underwent a ureteroscopic procedure for the treatment of ureteric calculi. The studied variables were patients and stones characteristics, in addition to the mean operative time and mean hospital stay, the stone-free rate, and complication rates were also calculated. Results: The overall success rate (complete stone clearance) in 587 patients was 550 patients (93.7%). Mean operative time was 26.1 minutes and mean hospital stay was <24 hours. The overall complication rate was 12%. The intra-operative complication rate was 3.2%, the early postoperative complication rate was 8 %, and the late postoperative complication rate was 0.85%. Conclusion: Growing skill and experience of ureteroscopy will lead to a significant increase in the success rate and reduce complications.

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A 10‐year experience of managing ureteric calculi: changing trends towards endourological intervention—is there a role for open surgery?

Cited by 62 publications

References 12 publications

Open mini‐access ureterolithotomy: the treatment of choice for the refractory ureteric stone?

Open mini‐access ureterolithotomy: the treatment of choice for the refractory ureteric stone?

Morbidity associated with surgical treatment of ureteric calculi in a teaching hospital in Kuwait

Ureteroscopy for management of ureteric calculi: Five years experience in Erbil, Iraq

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