Ureterorenoscopic Lithoclast Lithotripsy in the Management of Ureteric Stones; Does the Site of the Stone Affect the Results?

• Refaat Abusamra

  Department of Urology, Ibn Sina Teaching Hospital, Sirte, Sirte University, Libya

  Author

• Omran Aburgiga

  Department of Urology, Ibn Sina Teaching Hospital, Sirte, Sirte University, Libya

  Author

• Ali Ben Omran

  Department of Urology, the National Cancer Institute – Misurata, Libya

  Author

Ureteric stones carry a significant risk to the kidney function, high stress to the patients, and a high burden to the healthcare providers. Ureteroscopic Lithoclast Lithotripsy (URSL) is an efficient, cost-effective, safe treatment option for the treatment of ureteric stones. The current study aims to determine if the site of the ureteric stone might affect the result of URSL in the treatment of ureteric stones. Materials and Methods: A prospective interventional single-centre study that was carried out in the department of Urology in Ibn Sina Teaching Hospital in Sirt, Libya, in the period from January 2013 to December 2015. URSL was performed through Wolf semi-rigid ureteroscopes (7.5 F and/or 8.5 F). Results: The Study included 114 patients (76 males and 38 females). The average age was 42.5 years (age range 19-75 years).  The number of stones managed was 114. Of them, there were 30 stones (26.32%) in the upper ureter, 15 stones (13.16%) in the mid ureter, and 69 stones (60.53%) in the lower ureter. Stone sizes ranged from 5 to 15 mm (Average stone size: 10 mm). Overall stone-free rate reached 86% (70% in proximal ureteric stones, 80% in mid ureteric stones, and 94.2% in lower ureteric stones).   Discussion: URSL is least successful in proximal ureteric stones, and the best results were with (Distal) ureteric stones. In local current practice, it might be better to start with ESWL in upper ureteric stones. While Holmium, YAG laser lithotripsy remains the most successful and should be started when available. Conclusion: URSL is a safe and effective option in the treatment of ureteric stones, and it brings the best results in the case of distal ureteric stones. However, for stones in the proximal ureter, ESWL might be used first, or to go for YAG laser lithotripsy, which is superior.

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