[Antegrade endoscopic treatment of calculi of the ureter]

The author has treated 29 ureteric stones, situated in the lumbar ureter in 27 cases, via an antegrade endoscopic approach. On only one occasion, at the beginning of the series, the attempt failed due to loss of the nephrostomy tract. Another attempt failed in a case of an unusually hard stone in the pelvic segment of a congenital megaureter. In 18 out of 29 cases (62%), the stone was pushed back into the renal cavities and was extracted by percutaneous nephrotomy, in the absence of extracorporeal lithotripsy. The other 11 cases were treated by in situ lithotripsy (10 cases) or by Dormia basket extraction (1 case). Apart from the complete failures indicated above, there was also on partial failure following electric in situ lithotripsy in the iliac ureter. 26/29 cases were treated with complete success. There were no immediate complications and no cases of secondary stenosis. After a comparative analysis of the published series, the author concludes on the superiority of antegrade endoscopic treatment of lumbar ureteric stones over retrograde treatment by ascending ureteroscopy.