[Operative ureterorenoscope for the use of ultrasound and calculus extraction]

Ureteroscopy is used not only to clarify tumorous processes in the area of the ureter but also for removal or ultrasonic destruction of distal ureteral stones. Instruments have been developed that allow application of an optically controlled ultrasonic or metal loop. With our instrument we removed distal ureteral stones in 12 cases applying ultrasound or a Dormia loop. The different techniques and strategies are presented. In animal experiments we investigated the effect of ultrasound on the urothelium. We found that short time application (less than 30 s) does not leave irreversible damages. Removal of ureteral stones by ureteroscopy is indicated in stones which do not pass spontaneously or after unsuccessful efforts to remove the stones by means of a Zeissloop that is in cases where hitherto the only way of action possible was to carry out an ureterolithotomy.