Related Experiment Video
Updated: Jul 17, 2026

Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Primary ureteroscopy for distal-ureteral stones compared with ureteroscopy after failed extracorporeal lithotripsy
Volkan Tugcu1, Gokhan Gürbüz, Bekir Aras
1Department of Urology, Baklrkoy Training and Research Hospital, Istanbul, Turkey. volkantugcu@yahoo.com
Background And Purpose:
We reviewed our experiences with ureteroscopic pneumatic lithotripsy (URS-PL) for the treatment of distal-ureteral stones and investigated whether failed extracorporeal shockwave lithotripsy (SWL) is a limiting factor for the ureteroscopic procedure.
Patients And Methods:
We retrospectively studied the medical records of 375 patients treated with URS-PL from January 1999 to September 2005 in our clinic. Of these patients, 213 were treated with URS-PL primarily (group 1), whereas the remaining 162 patients had undergone SWL unsuccessfully before URS-PL was performed (group 2). We used 9F or 9.5F rigid instruments and the Vibrolith (Elmed, Ankara, Turkey).
Results:
In group 1, 206 patients (96.7%) were treated successfully with URS alone, as were 155 patients (95.6%) in group 2. Impacted stones were observed in 21 patients in group 1 (9.85%) and in 57 patients in group 2 (35.1%). The average operating time was 33.19 +/- 9.039 minutes in group 1 and 57.42 +/- 8.757 minutes in group 2. The stone-free rates of the two groups were significantly different on the first postoperative day, but this difference decreased to an insignificant level at the end of the first month.
Conclusion:
When SWL fails, URS-PL is as safe and effective as primary URS. Pneumatic lithotripsy also seems to be effective for impacted stones.
Related Concept Videos
Urinary Tract Calculi VI: Surgical Management
Urologic Endoscopic Procedure: Cystoscopic Examination
Imaging Studies V: Intravenous Urography and Retrograde Pyelography
Urinary Tract Calculi III: Medical Management
Imaging Studies II: Ultrasonography
Imaging Studies I: Kidney, Ureter, and Bladder Studies