[Anterograde ureteroscopy in the extraction of lumbar ureteral calculi]

Antegrade ureteroscopy can be used to extract certain lumbar ureteric stones in which the only alternative treatment is surgery. The technique of caliceal puncture is that of percutaneous nephrostomy: the ureteroscope is introduced through the Amplatz tube. The ureteric stone is removed by a basket probe, two-pronged forceps or hydroelectric shattering, 16 patients have undergone antegrade ureteroscopy; a rigid ureteroscope was used in 9 cases (2 residual fragments including 1 which migrated) and a flexible ureteroscope was used in 7 cases (3 failures). The overall success rate for the technique of 68% should improve with better selection of the indications (stone with a maximum diameter of 12 mm without retraction of the adjacent ureter and without kinking of the excretory tract) and with greater experience of the operators.