Cerrahpaşa Medical Journal

Our Experience of Semi-rigid Ureteroscopy with Pneumatic LithoClast for Impacted Upper Ureteric Calculi


Department of Urology, Hamdard University Hospital, Karachi, Pakistan


Department of Urology, Liaquat University of Medical and Health Sciences, Jamhsoro, Pakistan


Department of Surgery, Hamdard University Hospital, Karachi, Pakistan


Department of Urology, The Kidney Centre, Karachi, Pakistan

Cerrahpasa Med J 2023; 47: 168-170
DOI: 10.5152/cjm.2023.22090
Read: 373 Downloads: 201 Published: 19 July 2023

Objective: The aim of this study was to evaluate the outcome of using the semi-rigid ureteroscope and intracorporeal pneumatic lithotripsy on the impacted upper ureteric stones.

Methods: This is a retrospective study on patients who underwent ureteroscopy with pneumatic lithoclast fragmentation at Hamdard University Hospital from May 2018 to December 2021. Patients with impacted upper ureteric calculi > 1 cm and having a prior extracorporeal shock wave lithotripsy or medical expulsive therapy of more than 4 weeks were included. Those with persistent pain were also included. Patients <13 years of age, having a distal obstruction, who are pregnant, having spinal deformity, having morbid obesity, or on aspirin were excluded.

Results: Out of 72 patients, 53 (73.6%) were males, and the mean age was 39.57 ± 8.81 years. There was a single stone in 66 (91.6%) and multiple in 6 cases. The mean stone diameter was 1.12 ± 0.4 cm. The mean duration of surgery was 32.13 ± 9.71 minutes. The stone-free rate was 79.2% (n = 57), while it migrated in 15 (20.8%) patients which required additional extracorporeal shock wave lithotripsy sessions. A double-J stent insertion was done intraoperatively in 21 (29.1%) patients. No major operative or postoperative complications were observed.

Conclusion: Semi-rigid ureteroscope with pneumatic lithotripsy in an experienced hand is still a safe and useful treatment modality for impacted upper ureteric stones with good clearance rates and minimal complications.

Cite this article as: Haider A, Ahmed Memon W, Yaqoob U, et al. Our experience of semi-rigid ureteroscopy with pneumatic LithoClast for impacted upper ureteric calculi. Cerrahpaşa Med J. 2023;47(2):168-170.

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