Using retroperitoneal laparoscopic ureterolithotomy in the treatment of impacted upper ureteric calculi

BACKGROUND: The ideal treatment for upper ureteric calculi is still debatable, particularly for patients with large, impacted ureteric calculi. Retroperitoneal laparoscopic ureterolithotomy (RLU) may be a worthwhile alternative to open surgery. In this study, we retrospectively evaluated our clinical experience associated with RLU performed for impacted upper ureteric calculi (>1.5 cm) help urologists in clinical practice and provide a reference for clinical work. METHODS: A total of 64 cases (38 males; 26 females) with impacted upper ureteric calculi between April 2018 and January 2020 were analyzed retrospectively. The basic information of the included research subjects are as follows: The mean age was 50.8±25.4 years. The largest stone diameter was 1.8±0.3 cm. The mean stone retention time was 42±11 days. The mean degree of hydronephrosis was 2.8±1.2 cm. RESULTS: The mean operative time was 85.4±18.3 minutes. The mean hospital duration was 7.5±1.8 days. The stone-free rate was 98.4%. Two patients required additional intervention. Post-operative fever developed in 3 patients. The decrease in hemoglobin levels was 7.8±3.6 g/L. The increase in procalcitonin (PCT) level was 3.7±1.8 ng/mL. No major complications, for example, sepsis, bleeding, bowel injury, or cardiopulmonary morbidities, were reported. CONCLUSIONS: RLU should be regarded as an excellent first line treatment modality for impacted upper ureteric calculi (>1.5 cm) owing to the high success rate, low complication rate, and the short length of operative time and hospital duration.