Abstract

Salah Shebl Zeidan

To prospectively evaluate the outcome (safety, efficacy and complications) of ultrasonic lithotripsy aided by anti-migration tools and forceps in a management of distal ureteric stones. The study was conducted between October 2014 and October 2016 at urology department Al-Azhar University. A total of 70 patients with distal ureteric stones were selected. The mean Age was 43 (22 to 68) years. All underwent semi rigid ureteroscopy with ultrasonic lithotripsy in stone size ≤1.5 cm. Operative and postoperative data were evaluated and statistically analyzed. Fragmentation time was 85.2±50.2 minutes (fragmentation time was increased in stones with increased HU). Early (day after the operation) and delayed (one month later) stone free rates were estimated. Stone free rates for ureteroscopy using ultrasonic lithotripsy were 67/70 (95.7%). Three cases with residual (4.3 %) were extracted during JJ stent removal. Three stones have retrograde migration into dilated upper urinary tract 4.3% (clinically insignificant). Auxiliary procedure performed 50 cases (71.4 %), stone basket 28 cases (40%) used to clear stones after fragmentations and preventing migration of stones. No significant intraoperative or postoperative complications were encountered. Only minor complications as fever, mucosal abrasions and mild hematuria occurred. Postoperative stenting was JJ stent in 36 cases (51.4 %) and ureteric catheter 34 cases (48.6%). One case required second setting due to probe breakdown. Our study suggests that ultrasonic ureteric lithotripsy is safe and effective without significant complications in management of distal ureteric stones.