Use of the ureteroscope in ureteral calculus manipulation

The success rate of endoscopic manipulation of ureteral calculi is uncertain. The uncertainty arises because of selection procedures. A common reported figure is 50%, but this figure varies according to the selection procedure followed and the selection procedure depends on the anticipated difficulty of manipulation. The outcome of endoscopic manipulation performed as an initial procedure in a series of patients whose ureteral calculi required operative intervention is presented. A total of 33 calculi were successfully extracted by manipulation, including five in the upper ureter. The method failed to extract three calculi of which two were in the upper ureter. The success of this approach is attributed to the use of the rigid ureteroscope and the Meagher ureteral dilator, and to x-ray control.