Treatises
Cause analysis and management of ureteroscopic lithotripsy related ureteral stenosis
Sheng Ming, Chen Jiahui, Liu Xing, Bian Jun, Lai Dehui
Published 2023-02-01
Cite as IMHGN, 2023, 29(3): 409-413. DOI: 10.3760/cma.j.issn.1007-1245.2023.03.025
Abstract
ObjectiveTo analyze and discuss the causes and management of ureter stenosis after ureteroscopic lithotripsy.
MethodsThe clinical data of 60 patients with ureteral stenosis diagnosed by ureteroscopy after ureteroscopic lithotripsy admitted to The Fifth Affiliated Hospital of Guangzhou Medical University from December 2016 to December 2018 were retrospectively analyzed, including 28 males and 32 females, aged (48.1±10.5) years. All the patients were treated with ureteroscopic holmium YAG laser lithotripsy. All the patients did not have serious underlying diseases except for ureterolithiasis. The patients' age, gender, body mass index, and preoperative complications, and length, treatment methods, and treatment times of ureteral stenosis were recorded and analyzed.
ResultsThe follow-up period was (2.6±1.1) years. The length of ureteral stenosis was (1.7±1.2) cm. The times of surgical treatment of stenosis were (4.1±1.5) times. All the patients suffered from ureteral stenosis after ureteroscopic holmium YAG laser lithotripsy. Only 24 cases (40.0%) were successfully treated by endourological treatment (endoscopic balloon dilation combined with internal incision), 6 cases (10.0%) needed long-term indwelling of ureteral stent, 3 cases (5.0%) needed long-term indwelling of nephrostomy tube, 21 cases (35.0%) underwent urinary tract reconstruction, and 6 cases (10.0%) underwent nephrectomy for severe renal impairment.
ConclusionsThe successful rate of endoscopic surgery for ureteral stenosis after ureteroscopic holmium YAG laser lithotripsy is low. Therefore, we recommend against use of ureteroscopic holmium YAG laser lithotripsy. Gentle operation and appropriate lithotripsy are beneficial to reduce the incidence of postoperative ureteral stenosis.
Key words:
Ureteroscopy; Ureteral calculi; Ureteral stenosis; Holmium laser
Contributor Information
Sheng Ming
Department of Urology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou 510799, China
Guangzhou Key Laboratory of Enhanced Recovery After Surgery in Abdominal Surgery, Guangzhou 510799, China
Chen Jiahui
Department of Urology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou 510799, China
Guangzhou Key Laboratory of Enhanced Recovery After Surgery in Abdominal Surgery, Guangzhou 510799, China
Liu Xing
Department of Urology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou 510799, China
Guangzhou Key Laboratory of Enhanced Recovery After Surgery in Abdominal Surgery, Guangzhou 510799, China
Bian Jun
Department of Urology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou 510799, China
Guangzhou Key Laboratory of Enhanced Recovery After Surgery in Abdominal Surgery, Guangzhou 510799, China
Lai Dehui
Department of Urology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou 510799, China
Guangzhou Key Laboratory of Enhanced Recovery After Surgery in Abdominal Surgery, Guangzhou 510799, China
