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Category: Volume 07 Issue 07 July 2019
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Title: Impacted Mid Ureteric Stone: Comparative Study of Treatment by Transperitoneal Laparoscopic Ureterolithotomy versus Ureteroscopy

Authors: R K Maurya, Prabu R, Vinay Kumar, K B Mishra

 DOI: https://dx.doi.org/10.18535/jmscr/v7i7.166

Abstract

Objective: To compare the effectiveness and complications of ureteroscopy (URS) with pneumatic lithotripsy and transperitoneal laparoscopic ureterolithotomy (TPLU) in treatment of impacted mid ureteric stones larger than 1 cm.

Materials and Methods: In this prospective randomised study, 60 patients with impacted mid ureteric stone underwent URS with either pneumatic lithotripsy (group 1) or TPLU (group 2). Patient’s demographic profile, success rate, re-treatment rates, operation time, hospital stay, auxiliary procedures and complications were compared between group A and group B.

Results: Sixty patients (URS group 30, TPLU group 30) met inclusion criteria. It was seen that both methods were effective in the treatment of large mid ureteric stone; however, TPLU provide higher stone clearance rate (100 vs. 86.67%), lower complication rate and shorter operation time (61.66 ± 8.34 vs. 85.67 ± 7.62 min). On the other hand, patients treated with pneumatic ureteroscopy had less postoperative pain, shorter hospital stay and faster return to daily activities.

Conclusions: For treatment of impacted large mid ureteric stone, TPLU provides significantly higher success rate and lower retreatment rate compared with pneumatic ureteroscopy; however, URS provides similar stone free rates at three months as a minimal invasive procedure.

Keywords: Mid ureteric stones, pneumatic ureteroscopy, transperitoneal laparoscopic ureterolithotomy.

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Corresponding Author

Prabu R

Senior Resident, Department of Surgery, GSVM Medical College, Kanpur