Experience of treatment of the patients with the 1st-stage of ureteral calculus above L4 with a high lithotripsy rate by trans-urethral ureteroscopy holmium laser
Yu Ji
Liu Weijun
Li Jin
Shi Lei
Luo Chengbin
Liu Xiaoping
Abstract：Objective: To summarize the experiences of treatment of the patients with the 1st-stage of ureteral calculus above L4 with a high lithotripsy rate by trans-urethral ureteroscopy holmium laser.Methods: 269 cases of ureteral calculus who were treated by trans-urethral ureteroscopy holmium laser through a modification of intraoperative technique from Dec.2011 to Jun, 2016 were retrospectively analyzed, among them, there were 184 cases whose calculus was more than 4 cm away from the pelvis-ureter junction, and 85 cases whose calculus was equal to or less than 4 cm away from the pelvis-ureter junction.The maximum diameter of calculus was measured as 0.8-1.8 cm, averagely (1.2±0.2) cm, and collective systematic separation was 12-50 mm, averagely (20±4) mm.Results: There were 184 cases whose calculus was more than 4 cm away from the pelvis-ureter junction, and 168 cases were successfully cured by one-stage operation with the calculus clearance rate being 91.3%.There were 2 cases of N-shaped ureteral distortion, which were changed to receive a percutaneous renal lithotripsy to remove the calculus.There were 14 cases whose calculus was incompletely removed, and the remaining calculus needed to be treated by extracorporeal shock wave lithotripsy (ESWL).There were 85 cases whose calculus was equal to or less than 4 cm away from the pelvis-ureter junction, and 64 cases were successfully cured by one-stage operation with the calculus clearance rate being 75.3%.There were 5 cases of N-shaped ureteral distortion, which were changed to receive a percutaneous renal lithotripsy to remove the calculus.There were 16 cases whose calculus was incompletely removed, and the remaining calculus needed to be treated by ESWL.Conclusions: A high calculus clearance rate can be achieved by the trans-urethral ureteroscopy with a consideration of preoperative examination and intraoperative operational details in treating the L4-above ureteral calculus, which can be regarded as a preferential program characterized with less injury, convenient operation, short duration and relatively low cost.
Keywords：Ureteroscopeupper ureteral calculiabove L4holmium laser
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 154-157 )