To investigate the effect of 4 kinds of stone occluder in the treatment of upper ureteral calculi with middle primary lithotripsy under rigid ureteroscope.

The data of 131 patients with upper ureteral calculi treated with 4 different occluder devices during ureteroscopic holmium: YAG laser lithotripsy from July 2017 to March 2018 were retrospectively analyzed. Among them, 38 cases were treated with Cook N-trap and 15 cases were treated with Cook N-trap. Forty-two cases of Stone Cone and 36 cases of IVX-SC10 were performed. All the patients had stones above the 4th lumbar vertebra transverse process and complicated with different degrees of hydronephrosis. The specific method was to use Wolf 67.5 single channel ureteroscope, zebra guide wire guide to see stones, slowly cross stones in the lower space of stones, and operate the handle of occluder to block stones and fix stones, holmium laser in situ lithotripsy with the same working channel.The operation time, stone clearance rate and postoperative complications were analyzed.

The operation time was: N-trap(10.0-16.5)min, N-gage (8.0-12.5)min, Stone Cone(15.5-30.0)min and IVX-SC10(12.5-30.0)min. Five cases of calculi entered renal pelvis and calyx, of which 3 cases remained in renal pelvis, and continued ureteroscope to renal pelvis with holmium laser lithotripsy. After operation, 2 cases without residual stones were treated with extracorporeal shock wave lithotripsy (ESWL) and successful lithotripsy. The stone removal rate was 96.1%.There was no ureteral perforation or ureteral mucosal avulsion during operation, and fever occurred in 3 patients after operation and was improved after antibiotic treatment.

The ureteroscopy combined with occluder and holmium laser lithotripsy for the treatment of upper ureteral calculi is effective, safe and feasible, with high stone clearance rate, less postoperative complications, and significant reduction of flexible ureteroscope and percutaneous nephroscope surgery.

Ureteral Calculi; Ureteroscopy; Lasers, Solid-State