Prof. Petrisor GEAVLETE, MD, PhD.

Razvan Multescu, MD, PhD.

Bogdan Geavlete, MD, PhD.

Saint John Emergency Clinical Hospital Bucharest, Romania

7.5F 7.5F 8.0F 8.2F 8.5F 8.7F 9.0F 9.5F

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8/9.8F Wolf, 8 and 10F Storz, 8.5/9.9 F Olympus Endoeye digital semirigid ureteroscopes

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Balistic, electrohydaulic or Ho:YAG laser lithotripters.

Improved visibility

P.Geavlete, 2008 P.Geavlete, 2008 P.Geavlete, 2008 P.Geavlete, 2008 P.Geavlete, 2008

Intraoperative incidents (4.3%)

    

failure to negotiate de ureteral orifice (68 cases) failure to reach the calculi (237 cases) fixed stone baskets (69 cases) equipment damages (40 cases) double J stent malpositioning (12 cases) All the incidents were dealt endoscopically, except one case of fixed basket that imposed open extraction.

Intraoperative complications (2.8%)

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lesions of the ureteral mucosa (167 cases)

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perforation (68 cases)

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bleeding (26 cases)

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ureteral avulsion (3 cases)

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extra-ureteral stone migration (12 cases)

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All intraoperative complications were identified intraoperatively and treated immediately Open surgery was necessary in only 5 cases.

Lesions of the ureteral mucosa Perforation Fixed stone baskets P.Geavlete, 2000 P.Geavlete, 2009 P.Geavlete, 2007

CONCLUSIONS

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Due to technological advances and increased experience, the semirigid retrograde ureteroscopic treatment of ureteral lithiasis increased the efficacy, while the incidence of intraoperative complications decreased.

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Most of these complications are minor and can be managed by conservative approach.