Hussain A, Abdullah A, Shahid Shamim M, Kishwar M.
Uretroscopic Pneumatic Lithotripsy in complete clearance of Ureteric stones.
J Surg Pak Jan ;9(3):6-8.

Objectives: To evaluate the use of uretroscopic pneumatic lithotripsy in complete removal of ureteric stone. Patients And Methods: A descriptive study was undertaken from January -2000-to December 2003 at Ziauddin University Hospital and Liaquat National Hospital Karachi. All patients diagnosed with stone in middle or lower ureter that fulfilled the inclusion criteria were enrolled in the study. Inclusion criteria was: (1) lower or mid ureter stone of 0.5 to 1.5 cm size, (2) lumbar or loin to groin pain poorly responding to analgesia, (3) delayed functioning or non-functioning kidney on intra-venous pyelogram, (4) associated urinary tract infection, or (5) less than 0.5 cm stone that did not respond to at least four weeks of conservative treatment. Enrolled patients underwent rigid ureteroscopy (URS) and stone was fragmented by using pneumatic lithotriptor by single or multiple fire technique at a single sitting. Follow-up was done to evaluate the completion of stone removal. Results: During the defined period 324 (269 male and 55 female, ratio 4.8:1) patients were enrolled into the study. Their age ranged from 16 to 80 years (median 48 years). Eighty patients had stone in middle ureter while 244 were in lower ureter. Stone was in the right ureter in 152, left ureter in 168 and bilateral in four patients. Out of the total, 285 (87.9%) patients had their stones removed without any complication during or after the procedure. Seventy out of these were done as day care surgeries. Double J stent was placed in 15 (4.6 %) patients due to greater stone load. Complete removal of stone was not achieved in 39 (12.0 %) patients in single sitting of URS and pneumatic lithotripsy, out of which only one required open surgery. Conclusion: URS in experienced and trained hands is safe, effective and cost effective for lower and mid ureteric stones requiring intervention.

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