[Removal of ureteral calculi by uteroscopy]

Ureteral stones can now be removed endoscopically, using a ureteroscope. This instrument, provided with a direct optic system and an operating tube, is introduced under general anaesthesia after the ureteral opening has been dilated and is pushed up until it reaches the stone which is then removed by means of a basket catheter or a forceps. Voluminous stones can be shattered in situ by ultrasounds or hydroelectric shock waves. Forty-three stones, representing 72% of all attempts, were removed by this method from 30 patients. There were 6 failures due to impassable vesico-ureteral opening, ureteral flexure and wedged in or ascended stone, and 4 complications including 2 cases where the basket catheter went under the mucosa and 1 case each of secondary urinoma and ureteral clotting. There was no perforation nor overt septic complication. Most stones were larger than 10 X 4.5 mm and were located in the pelvic or iliac part of the ureter. Infected stones can be removed endoscopically under antibiotic treatment and provided a draining catheter is left in place. Ureteroscopy notably reduces the need for ureteral lithotomy.