Semirigid ureteroscopy in management of large proximal XXXX : is there still a role in developing countries?

@entity1 @entity3041 @entity1607 @entity811 @entity221
OBJECTIVES: To evaluate the outcome and complications of the use of semirigid ureteroscopy (URS) together with intracorporeal pneumatic lithotripsy in the management of upper @entity1607 >10 mm in diameter. METHODS: A total of 75 @entity1 (41 @entity1 and 34 @entity1 ), with a mean age of 48 years (range 25-60), underwent primary URS for solitary radiopaque proximal @entity1607 10-20 mm in diameter (average 13.1). Dilation of the intramural ureter was done in 60 cases (80% of @entity1 ), and intracorporeal lithotripsy was required in 56 (74.6%). Ureteral catheters were left for drainage in 60% of @entity1 , 26.7% were left unstented, and only 13.3% required an indwelling stent. RESULTS: Of the 75 stones, 60 (80%) were successfully cleared after a single endoscopic procedure. Our initial stone-free rate was 90.6% at 2 weeks after the primary endoscopic procedure and had reached 98.6% at 3 months. Antegrade URS for migrating stones was done successfully in 6 cases in a tubeless fashion, and open ureterolithotomy was required in 1 case. No major complications were encountered. The minor complications included only mild extravasation and self-limited postoperative @entity221 and @entity811 . The risk factors for URS failure included male gender, the severity of the @entity3041 , the severity of impaction, and the occurrence of extravasation. CONCLUSIONS: The results of our study have shown that semirigid URS is a safe and successful alternative to open ureterolithotomy in the management of large proximal @entity1607 in the absence of flexible instruments.
