[Limitations and complications of the use of the basket]

During the last 15 years the Dormia stone dislodger has been used in 352 cases (80%) out of 435 of ureteral stones: 318 were at ileo pelvic, 34 at lumbar level. 303 ileo pelvic and 21 lumbar stones have been successfully removed (92%). Considering that the probability of stone removal is directly proportional to the ureteral expansibility and indirectly proportional to the volume of the stone, the Basket technique isn't indicated: When the stone is more than 1 cm.; When the ureter is widely stiff (as in Ormond d. or post-radiotherapy stiffness); When stenosis is present. The impossibility of bypassing the stone, the insufficient expansion of the Basket, the stone irremovability and the difficult extraction through the meatus, my limit the successes of this technique while iperating. The immediate complications have been: 4 sectoral rips of the mucosa surrounding the ureteral end, cured by catheterisation without aftereffects (1.2%); 1 sliding of the ureter through the trigone up to urethral meatus (in a woman), which has been repaired, without aftereffects, by direct catheterisation of the ureter, out of the urethra, after removal of the Basket and stone from the ureteral extremity. (0.3%) Strictures occurred in 5 cases (1.5%) and vescicoureteral reflux in 6 (1.8%). These results of the sole Basket technique (performed according to the well-known directions) seem to be much better than those (which have been illustrated) obtained with the endoscopic lithotripsy.