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• W2061029700 abstract "No AccessJournal of UrologyClinical Urology: Original Articles1 Jan 1998SECONDARY URETEROSCOPY: RESULTS AND MANAGEMENT STRATEGY AT A REFERRAL CENTER Rajiv K. Singal, Hassan A. Razvi, and John D. Denstedt Rajiv K. SingalRajiv K. Singal More articles by this author , Hassan A. RazviHassan A. Razvi More articles by this author , and John D. DenstedtJohn D. Denstedt More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)64010-2AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: In an era when extracorporeal shock wave lithotripsy occupies a dominant place in the treatment of urolithiasis ureteroscopy retains an important role in certain circumstances. While often a definitive procedure, ureteroscopy can be associated with potential risks and complications. The treatment of patients who have undergone a failed attempt at ureteroscopic stone retrieval or have a complication may be complex. As a tertiary care stone referral center we review our experience with performing salvage ureteroscopy following a previous unsuccessful attempt at endoscopic stone removal. Materials and Methods: Between May 1990 and February 1996, 79 patients were referred following an unsuccessful attempt at retrograde endoscopic or basket manipulation for ureteral calculi. A retrospective review of the outcomes of these patients was conducted. Of the patients 11 presented with associated complications, which included ureteral perforation[4], intramural false passage[1] and fever or sepsis[6]. Complications were managed by early establishment of urinary tract drainage by stenting or nephrostomy. Among patients without complications elective salvage ureteroscopy was performed. Results: Ureteroscopy was used in 79 patients with a successful outcome (stone-free) in 75 (95%). Followup imaging with renal ultrasound or excretory urography at least 3 months after secondary ureteroscopy was available in 65 patients and showed no evidence of hydronephrosis or delayed stricture formation. Conclusions: Treating the patient who undergoes a failed attempt at ureteroscopy may be problematic and requires access to a wide array of endourological equipment. Each subsequent treatment should be individualized with consideration given to stone size, location and general health. In the presence of a ureteral injury establishment of early urinary tract drainage is essential. Following stabilization, secondary ureteroscopy can be performed yielding high stone-free rates with minimal complications. References 1 : Contemporary management of ureteral stones.. Urol. Clin. N. Amer.1997; 24: 59. Google Scholar 2 : Extracorporeal shock wave lithotripsy for ureteral stones: a retrospective analysis of 417 cases.. J. Urol.1988; 139: 513. Abstract, Google Scholar 3 : Lumbar ureteric stones: which is the best treatment?. Urology1991; 38: 443. Google Scholar 4 : Extracorporeal shock wave lithotripsy in situ or after push-up for upper ureteral calculi: a prospective randomized trial.. J. Urol.1993; 150: 824. Abstract, Google Scholar 5 : Extracorporeal shock wave lithotripsy for ureteral stones using the Dornier lithotriptor MFL5000.. Urol. Int.1994; 52: 98. Google Scholar 6 : Ureteroscopy for lower ureteral stones (editorial).. Urology1993; 42: 356. Google Scholar 7 : The case for primary endoscopic management of upper urinary tract calculi: I. A critical review of 121 extracorporeal shock-wave lithotripsy failures.. Urology1995; 45: 363. 7.. Google Scholar 8 : Cost and efficacy of extracorporeal shock wave lithotripsy versus ureteroscopy in the treatment of lower ureteral calculi.. J. Urol.1992; 148: 1095. Abstract, Google Scholar 9 : Cost comparison analysis of extracorporeal shock wave lithotripsy versus ureteroscopic laser destruction of distal ureteral stones. J. Urol.1988; 139: 292A. part 2, abstract 517. Google Scholar 10 : Ureteroscopy.. J. Urol.1988; 139: 510. Abstract, Google Scholar 11 : Ureteral perforation during ureteroscopy: treatment and management.. J. Urol.1987; 138: 36. Abstract, Google Scholar 12 : Complications of ureteral endoscopy.. J. Urol.1987; 137: 649. Abstract, Google Scholar 13 : Late sequelae of the management of ureteral calculi with the ureteroscope.. J. Urol.1986; 136: 386. Abstract, Google Scholar 14 : Ureteroscopy: results and complications.. J. Urol.1987; 137: 865. Abstract, Google Scholar 15 : Complications associated with ureteroscopy.. Brit. J. Urol.1986; 58: 625. Google Scholar 16 : Ureteroscopy: current practice and long-term complications.. J. Urol.1997; 157: 28. Google Scholar 17 : Do inefficient and futile attempts at treating ureteric stones lower the success rate of definitive treatment?. J. Endourol., suppl.1995; 9: S62. Google Scholar 18 : The case for primary endoscopic management of upper urinary tract calculi: II. Cost and outcome assessment of 112 primary ureteral calculi.. Urology1995; 45: 372. Google Scholar 19 : Advances in intracorporeal lithotripsy.. Cur. Op. Urol.1995; 5: 212. Google Scholar From the Division of Urology, The University of Western Ontario, London, Ontario, CanadaAccepted for publication June 6, 1997(Denstedt) Requests for reprints: St. Joseph's Health Centre, 268 Grosvenor St., London, Ontario, Canada NGA 4V2© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited bySOFER M, WATTERSON J, WOLLIN T, NOTT L, RAZVI H and DENSTEDT J (2018) HOLMIUM: YAG LASER LITHOTRIPSY FOR UPPER URINARY TRACT CALCULI IN 598 PATIENTSJournal of Urology, VOL. 167, NO. 1, (31-34), Online publication date: 1-Jan-2002. Volume 159Issue 1January 1998Page: 52-55 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information Rajiv K. Singal More articles by this author Hassan A. Razvi More articles by this author John D. Denstedt More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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