Using retroperitoneal laparoscopic ureterolithotomy in the treatment of impacted upper ureteric calculi

The ideal treatment for upper ureteric calculi is still debatable, particularly for patients with large, impacted ureteric calculi. Retroperitoneal laparoscopic ureterolithotomy (RLU) may be a worthwhile alternative to open surgery. In this study, we retrospectively evaluated our clinical experience associated with RLU performed for impacted upper ureteric calculi (>1.5 cm) help urologists in clinical practice and provide a reference for clinical work.

A total of 64 cases (38 males; 26 females) with impacted upper ureteric calculi between April 2018 and January 2020 were analyzed retrospectively. The basic information of the included research subjects are as follows: The mean age was 50.8±25.4 years. The largest stone diameter was 1.8±0.3 cm. The mean stone retention time was 42±11 days. The mean degree of hydronephrosis was 2.8±1.2 cm.

The mean operative time was 85.4±18.3 minutes. The mean hospital duration was 7.5±1.8 days. The stone-free rate was 98.4%. Two patients required additional intervention. Post-operative fever developed in 3 patients. The decrease in hemoglobin levels was 7.8±3.6 g/L. The increase in procalcitonin (PCT) level was 3.7±1.8 ng/mL. No major complications, for example, sepsis, bleeding, bowel injury, or cardiopulmonary morbidities, were reported.

RLU should be regarded as an excellent first line treatment modality for impacted upper ureteric calculi (>1.5 cm) owing to the high success rate, low complication rate, and the short length of operative time and hospital duration.