Abstract

Objective: We have analyzed the difficult cases in ureterorenoscopic surgery in this study. 

Materials and methods: We have evaluated 117 patients’ records retrospectively that has operated because of ureteric stone with ureterorenoscopy, which were evaluated as difficult cases in our clinic between 2001-2008. Difficult case criteria were the stricture that prevents or makes difficult the passage of ureterorenoscope in the ureter, the upper ureteric stones, previous ureteric surgery, high risk patients due to comorbidity.

Results: The localization of the stones were 77.8% (n=91) upper ureter, 8.5% (n=10) middle ureter, and 13.7% (n=16) lower ureter. The stricture of ureter that complicates the surgery was seen at the first distal 5 cm in 82% (n=96) of the patients (p<0.05). Of the patients, 40.9% (n=47) failed to continue operations due to stricture of the ureter. The operation failure were detected in 39% of lower, 70% of middle, and 25% of upper ureter localized stones.

Conclusion: Endoscopic ureter stone surgery could safely be performed in difficult cases. Ureteral stricture might be the one of the frequent factors.