Upper ureteral calculi: extraction via percutaneous nephrostomy.

Area of Science:

• Urology
• Nephrology
• Endourology

Background:

• Symptomatic upper ureteral calculi often require surgical or endoscopic intervention.
• Percutaneous nephrostomy offers an alternative approach for stone removal.

Purpose of the Study:

• To evaluate the efficacy of percutaneous nephrostomy for extracting upper ureteral calculi.
• To assess sequential techniques used during percutaneous nephrostomy for stone removal.

Main Methods:

• Percutaneous nephrostomy was employed in 37 patients with symptomatic upper ureteral calculi.
• Sequential techniques included retrograde catheter push, basket sheath exchange, and steerable loop-snare.

Main Results:

• Successful extraction was achieved in 35 of 37 patients (94.6%).
• Retrograde catheter dislodged calculi into the renal pelvis in 12 patients, facilitating easier extraction.
• Stone basket retrieval was successful in 17 patients; a steerable loop-snare was required for six patients due to basket retrieval failure.

Conclusions:

• Percutaneous nephrostomy is a highly effective method for removing symptomatic upper ureteral calculi.
• A combination of retrograde catheter push, basket retrieval, and loop-snare techniques offers a versatile approach to stone extraction.