The transvesical approach for the removal of distal ureteral calculi

Our experience with a modification of transvesical ureterolithotomy in 12 patients in whom endourological extraction failed is presented and the technique is described. Successful removal of stones was achieved in all patients with 1 significant postoperative complication of a perivesical hematoma, which was drained percutaneously. Excretory urography and voiding cystourethrography at 3 months and 1 year postoperatively demonstrated no ureteral stricture or vesicoureteral reflux. When removal of distal ureteral stones by endourological means or extracorporeal shock wave lithotripsy fails, we recommend transvesical ureterolithotomy as an easy and rapid approach that necessitates minimal dissection away from blood vessels and avoids manipulation or displacement of the ureteral orifice.