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Retrograde Ureteroscopy in the Management of Distal Ureteric Stones: A Retrospective Analysis of Outcome and Complications

BACKGROUND: Urinary stones affect 8%–15% of the world population. In Nigeria, contemporary reports have shown that the incidence of urinary stones is rising. The distal ureter has been described as the most common location of ureteric stones. This study seeks to review our experience in the ureteros...

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Autores principales: Akpayak, Idorenyin Cletus, Agbo, Christian A., Nabasu, Lemech E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8015960/
https://www.ncbi.nlm.nih.gov/pubmed/33243949
http://dx.doi.org/10.4103/aam.aam_65_19
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author Akpayak, Idorenyin Cletus
Agbo, Christian A.
Nabasu, Lemech E.
author_facet Akpayak, Idorenyin Cletus
Agbo, Christian A.
Nabasu, Lemech E.
author_sort Akpayak, Idorenyin Cletus
collection PubMed
description BACKGROUND: Urinary stones affect 8%–15% of the world population. In Nigeria, contemporary reports have shown that the incidence of urinary stones is rising. The distal ureter has been described as the most common location of ureteric stones. This study seeks to review our experience in the ureteroscopic management of distal ureteric stones with a view to appraising the stone clearance rate and the complications seen in our patients. PATIENTS AND METHODS: This descriptive study reviewed the record of 21 patients, who had semirigid ureteroscopy and pneumatic lithotripsy for distal ureteric stone between October 2015 and September 2018. All patients had computed tomography urography preoperatively to locate the stone. Data on patients' demographics, indication for the surgery, location and size of stone, preoperative double-J (DJ) placement, postoperative DJ stent placement, intraoperative and postoperative complications, and status of stone clearance were retrieved and subjected to statistical analysis. RESULTS: The mean age of the patients was 37.95 ± 11.09 (range, 21–67) years. The mean stone size was 8.06 ± 2.87 mm with a range of 4.8 mm–15.0 mm. Out of the 21 patients, 20 (95.2%) had the procedure for recurrent ureteric colic and 1 (48%) was for hematuria. Four (19.0%) patients had DJ stent preoperatively, whereas 17 (81.0%) patients did not have. Fourteen (66.7%) patients had intraoperative ureteric dilatation. Postoperative DJ stent was placed in 17 (81.0%) patients, whereas 4 (19.0%) patients did not have. Three (14.3%) patients had mucosal flap, 6 (14.3%) had mucosal abrasion, 2 (9.5%) had bleeding, 1 (4.8%) patient had transient hematuria postoperatively, and 2 (9.5%) patients had urinary tract infection. Nineteen (90.5%) patients had complete clearance in a single surgery. Two (9.5%) patients had symptomatic residual fragments that required repeat ureteroscopy. CONCLUSION: Our study has shown that ureteroscopy is a useful and safe technique in the removal of stones in distal ureter.
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spelling pubmed-80159602021-04-05 Retrograde Ureteroscopy in the Management of Distal Ureteric Stones: A Retrospective Analysis of Outcome and Complications Akpayak, Idorenyin Cletus Agbo, Christian A. Nabasu, Lemech E. Ann Afr Med Original Article BACKGROUND: Urinary stones affect 8%–15% of the world population. In Nigeria, contemporary reports have shown that the incidence of urinary stones is rising. The distal ureter has been described as the most common location of ureteric stones. This study seeks to review our experience in the ureteroscopic management of distal ureteric stones with a view to appraising the stone clearance rate and the complications seen in our patients. PATIENTS AND METHODS: This descriptive study reviewed the record of 21 patients, who had semirigid ureteroscopy and pneumatic lithotripsy for distal ureteric stone between October 2015 and September 2018. All patients had computed tomography urography preoperatively to locate the stone. Data on patients' demographics, indication for the surgery, location and size of stone, preoperative double-J (DJ) placement, postoperative DJ stent placement, intraoperative and postoperative complications, and status of stone clearance were retrieved and subjected to statistical analysis. RESULTS: The mean age of the patients was 37.95 ± 11.09 (range, 21–67) years. The mean stone size was 8.06 ± 2.87 mm with a range of 4.8 mm–15.0 mm. Out of the 21 patients, 20 (95.2%) had the procedure for recurrent ureteric colic and 1 (48%) was for hematuria. Four (19.0%) patients had DJ stent preoperatively, whereas 17 (81.0%) patients did not have. Fourteen (66.7%) patients had intraoperative ureteric dilatation. Postoperative DJ stent was placed in 17 (81.0%) patients, whereas 4 (19.0%) patients did not have. Three (14.3%) patients had mucosal flap, 6 (14.3%) had mucosal abrasion, 2 (9.5%) had bleeding, 1 (4.8%) patient had transient hematuria postoperatively, and 2 (9.5%) patients had urinary tract infection. Nineteen (90.5%) patients had complete clearance in a single surgery. Two (9.5%) patients had symptomatic residual fragments that required repeat ureteroscopy. CONCLUSION: Our study has shown that ureteroscopy is a useful and safe technique in the removal of stones in distal ureter. Wolters Kluwer - Medknow 2020 2020-11-25 /pmc/articles/PMC8015960/ /pubmed/33243949 http://dx.doi.org/10.4103/aam.aam_65_19 Text en Copyright: © 2020 Annals of African Medicine http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Akpayak, Idorenyin Cletus
Agbo, Christian A.
Nabasu, Lemech E.
Retrograde Ureteroscopy in the Management of Distal Ureteric Stones: A Retrospective Analysis of Outcome and Complications
title Retrograde Ureteroscopy in the Management of Distal Ureteric Stones: A Retrospective Analysis of Outcome and Complications
title_full Retrograde Ureteroscopy in the Management of Distal Ureteric Stones: A Retrospective Analysis of Outcome and Complications
title_fullStr Retrograde Ureteroscopy in the Management of Distal Ureteric Stones: A Retrospective Analysis of Outcome and Complications
title_full_unstemmed Retrograde Ureteroscopy in the Management of Distal Ureteric Stones: A Retrospective Analysis of Outcome and Complications
title_short Retrograde Ureteroscopy in the Management of Distal Ureteric Stones: A Retrospective Analysis of Outcome and Complications
title_sort retrograde ureteroscopy in the management of distal ureteric stones: a retrospective analysis of outcome and complications
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8015960/
https://www.ncbi.nlm.nih.gov/pubmed/33243949
http://dx.doi.org/10.4103/aam.aam_65_19
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