Year : 2016 | Volume
: 8 | Issue : 2 | Page : 189--192
Large proximal ureteral stones: Ideal treatment modality?
B Kadyan, V Sabale, D Mane, V Satav, A Mulay, N Thakur, SP Kankalia
Department of Urology, Dr. D. Y. Patil Medical College, Pimpri, Pune, Maharashtra, India
Background and Purpose: Ideal treatment modality for patients with large impacted proximal ureteral stone remains controversial. We compared laparoscopic transperitoneal ureterolithotomy (Lap-TPUL) and semirigid ureteroscopy for large proximal ureteric stones to evaluate their efficacy and safety.
Patients and Methods: From November 2012 to December 2014, we enrolled 122 patients with large (≥1.5 cm) proximal ureteral stone in the study. Patients were randomly divided into two groups: Group A (60 patients), retrograde ureteroscopic lithotripsy using a semirigid ureteroscope; Group B (62 patients), transperitoneal LU (Lap-TPUL).
Results: The overall stone-free rate was 71.6% and 93.5% for Group A and Group B respectively (P = 0.008). Auxiliary procedure rate was higher in Group A than in Group B (27.3% vs. 5.6%). The complication rate was 11.2% in Group B versus 25% in Group A. Mean procedure time was higher in laparoscopy group as compared to ureterorenoscopy (URS) groups (84.07 ± 16.80 vs. 62.82 ± 12.71 min). Hospital stay was 4.16 ± 0.67 days in laparoscopy group and 1.18 ± 0.38 days in URS group (P < 0.0001).
Conclusion: Laparoscopic transperitoneal ureterolithotomy is a minimally invasive, safe and effective treatment modality and should be recommended to all patients of impacted large proximal stones, which are not amenable to URS or extracorporeal shock-wave lithotripsy or as a primary modality of choice especially if patient is otherwise candidate for open surgery.
Department of Urology, Dr. D. Y. Pati l Medical College, Pimpri, Pune - 411 018, Maharashtra
|How to cite this article:|
Kadyan B, Sabale V, Mane D, Satav V, Mulay A, Thakur N, Kankalia S P. Large proximal ureteral stones: Ideal treatment modality?.Urol Ann 2016;8:189-192
|How to cite this URL:|
Kadyan B, Sabale V, Mane D, Satav V, Mulay A, Thakur N, Kankalia S P. Large proximal ureteral stones: Ideal treatment modality?. Urol Ann [serial online] 2016 [cited 2020 Feb 26 ];8:189-192
Available from: http://www.urologyannals.com/article.asp?issn=0974-7796;year=2016;volume=8;issue=2;spage=189;epage=192;aulast=Kadyan;type=0