Bilateral single-session ureteroscopy with pneumatic lithotripsy for bilateral ureter stones: feasible and safe

To evaluate the feasibility and safety of bilateral single-session ureteroscopy in the treatment of bilateral stones with different localizations.

Between February 2001 and October 2006, a total of 1,296 patients underwent ureteroscopy with pneumatic lithotripsy. Of these, 38 patients (2.9%) had bilateral ureter stones. The stones were located in the lower, middle and upper ureter in 44 (57.9%), 21 (27.6%) and 11 (14.5%) of the cases, respectively. Fifty-one stones (67.1%) were less than 1 cm.

Of the 76 stones, 67 (88.1%) were fragmented in a single procedure. The stone clearance rate was 93.1% after the second session. According to the localization of the stones, the stone clearance rate after single endoscopic session was 72.7% for upper ureteral calculi, 80.9% for midureter and 95.4% for lower ureter stones. For patients with calculi less than 1 cm and greater than 1 cm, the initial stone-free rate after ureteroscopy was 94.1% (48 of 51) and 76% (19 of 25), respectively (p < 0.05). No major complication was observed.

Bilateral single-session pneumatic lithotripsy can be performed safely and has high success rates with minimal morbidity and short hospital stay.