Author : H. Saeed, Nooman
Ureteric stone management: comparison of ureteroscopy using pneumatic lithotripsy with ureterolithotomy results
Annals of the College of Medicine, Mosul,
Volume 39, Issue 1, Pages 70-74
Objective: The purpose of this study is to compare ureteroscopy using pneumatic lithotripsy with open surgery (ureterolithotomy) in treating ureteric stones regarding the success rate, procedures time, need for post-operative analgesia, duration of hospital stay, and complications rate.
Patients and methods: A prospective study of 90 patients suffering from ureteric stones, referred to the urology center at Al- Jumhori Teaching Hospital in Mosul city between 1st of May 2010 – 31st of March 2011. Fifty patients were treated by ureteroscopy and 40 patients by ureterolithotomy. Their age and sex distribution was comparable. Results of both treatment modalities were analyzed and compared.
Results: The success rate for ureteroscopy was 90% and for ureterolithotomy was 97.5%. The procedure time was significantly shorter for ureteroscopy patients (21 minute versus 67 minute). Mean post-operative analgesia was much less for ureteroscopy (1.1 versus 9.5 analgesic injections). Ninety two percent of ureteroscopy patients were discharged at same day of operation with mean hospital stay of 1.12 days compared to 3.5 days for ureterolithotomy group. Complications were reported in 8% in ureteroscopy and 5% in ureterolithotomy group.
Conclusion: The success rate of ureteroscopic procedures using pneumatic lithotripsy is comparable to that of ureterolithotomy, but with significantly shorter procedure time, less need for post-operative analgesia, shorter hospital stay, and with no significant increase in the complications rate. These results mean early return to social life and activities, and make ureteroscopy a preferable option for treating ureteric stone when facilities and surgical skills are available.