A Review of Ureteroscopic Surgery in Sulaimaniya Teaching Hospital

Abstract

ABSTRACT

Background: Indications for ureteroscopy fall into two categories; diagnostic and therapeutic. Diagnostic indications include evaluating patient with radiological filling defect, haematuria, positive cytology of the upper tract, surveillance of patients with upper tract malignancy that treated endoscopically. Therapeutic indications include: removing upper tract stones or other foreign bodies, treating upper tract malignancy, treating strictures or treating areas of obstruction

Objectives: To evaluate the minimum invasive method for the treatment of ureteric pathology (mostly stone disease) in our center, and to determine the safety and efficacy of ureteroscopic surgery

Methods: A prospective study of 50 patients with urinary disease who had undergone ureteroscopic surgery at the Sulaimaniya Teaching Hospital from January 2007 to December 2007 for diagnostic and therapeutic purposes. Semi-rigid ureteroscope was used either 8F (Karl Storz) or 10.5 F (Scholly's) over the safety guide wire. Pneumatic intracorporeal lithotripsy (Karl Storz Calcusplit) has been used for fragmentation of the stones. The patients were discharged from hospital within 24-72 hours.

Results: Fifty-one ureteroscopies were done for 50 patients, 23 ureteroscopies for left side (46%) and 26 ureteroscopies for right side (52%) and bilateral for one patient (2%). Diagnostic ureteroscopy performed for 8 patients and therapeutic ureteroscopy performed for 42 patients. The stone free rate in proximal ureter was 75% and in distal ureter was 85.7%, the stone free rate for stones < 10 mm was 88.9% and for stones >10 mm the stone free rate was 73.7%.

Conclusion: Ureteroscopy is an attractive method for management of ureteric stone, especially lower ureteric stones. Ureteroscopy is a safe procedure because of its low percentage of significant tissue trauma.