Treatment For Lower Ureteral Stone Complicated With Ipsilateral Lower Calyx Calculi Through Combining Rigid And Flexible Ureteroscopy

Objective:To evaluate the feasibility, safety and efficacy of treatment for lower ureteral stone complicated with ipsilateral lower calyx calculi through combining rigid and flexible ureteroscopy.Methods:From January 2010 to May 2011, Twelve patients underwent combining rigid and flexible ureteroscopy with holmium laser lithotripsy for lower ureteral stone and ipsilateral lower calyx calculi in our hospital. Seven cases were male, average age was 41(22～67). The renal stones were either removed intact with basket or fragmented with the laser to small pieces (≤3mm), with basket removal of larger fragments. Every patient received KUB and non-contrast CT scan before operation, Six cases whose stones were located in left, others were located in right. mean lower ureteral stone size was 0.9*0.8cm(1.5*0.9～0.8*0.7); lower calyx calculi size was0.8*0.6cm(1.3*0.7～0.6*0.5), mean lower calyx calculi number were 2 drops(1-5); All patients took KUB in the first day postoperatively, and evaluate stone free rate, A follow-up by KUB or non-contrast CT scan was done two weeks after the procedure to evaluate the stone evacuation rate.Results:All patients' operations were successful, mean operation time was 68 min(40-90min); Mean operative time for using flexible ureteroscopy treated lower calyx calculi was 20 min(10-40min); Mean bleeding quantity was 10 ml, No patient had ureteric perforation or septic shock in or after the surgery. Mean time of post-operative stay in hospital was 3 days(2-4d); ureteral stone free rate was 100%, renal stone free rate was92.5%, one case underwent ESWL after operation, renal stone evacuation rate was 100% two weeks after operation.Conclusion:Combined ureteroscopic treatment for lower ureteral and ipsilateral lower calyx calculi is a safe and attractive option for patients presenting for symptomatic ureteral stone and ipsilateral small lower calyx calculi.