Complications of ureteroscopy in relation to experience: report of survey and author experience

During the last 4 years we performed ureteroscopy for diagnostic evaluation in 20 patients and for removal of mid or distal ureteral stones in 127. All of the diagnostic studies were successful. In the stone removal cases the success rate increased from 71 per cent for the 24 procedures done during the first 2 years to 92 per cent for the 60 procedures done in the first 9 months of 1985. The rate of ureteral injury in the entire series was 2 per cent and in only 9 of the 23 failures was an open operation necessary. The benefit of experience also was evident in the results reported by 28 medical centers, with a 78 per cent success rate at the 11 centers that had performed less than 20 procedures each and an 84 per cent success rate at the 9 centers that had done more than 50. Despite early frustration with ureteroscopy, the value of mastering the technique allows the urologist to proceed endourologically with minimum morbidity and without precluding further interventional procedures.