To Evaluate the Outcome of Surgical Treatment of Ureteric Calculus with Ureterorenoscopy Followed by Pneumo Lithotripsy

Background: Various methods have been adopted for the removal of ureteric calculi. Ureteroscopic pneumatic lithotripsy has been used to treat ureteric calculi for more than a decade. Objectives: To determine successful stone fragmentation by ureteroscopic pneumatic lithotripsy in the management of ureteric calculi as well as intra-operative and post-operative complications related to it. Materials and Methods: Fifty patients having ureteric stones were treated with intracorporeal pneumatic lithotripsy. The size, side and site of stones along with the results of preoperative routine investigations were noted in the patients. The pneumatic lithotripter was introduced through a rigid ureteroscope (Karl Storz) to break the stones. Successful stone fragmentation, lithotripsy time, intra-operative and post-operative complications were recorded. Results: Complete stone fragmentation was achieved in about 92 % of cases. The mean lithotripsy time was 21 minutes. About 92% of patients were stone-free at one week follow-up after the procedure, 96% by the end of eight weeks while 100% stone-free status was achieved by the end of 12 weeks. The mean hospital stay was 1.82 days and complications (both significant and minor) occurred in 24 % of cases. However, majority of them were minor and successfully managed. Conclusion: Intra-operative pneumatic lithotripsy is a minimally invasive, effective and rapid procedure for the management of ureteric calculi. Though it can give rise to considerable complications, they are mainly minor. It seems to be a good alternative in patients where ESWL is unsuccessful or not indicated and in patients who need early stone removal.