Long-term experience with transurethral rigid ureteroscopy as a complementary method to extracorporeal shockwave lithotripsy.

Between May 1985 and September 1990, 291 ureteroscopies were performed either for primary or secondary stone therapy or for diagnostic purposes. Rigid ureteroscopes (12.5 or 9.5 French) were used without dilation of the ureteral orifice. 83% of the stones could be removed either by direct extraction or electrohydraulic or ultrasound lithotripsy. The highest failure rates (25.6%) occurred in stones located in the upper ureter, the lowest failure rate (9.6%) resulted from treatment of lower ureteral stones. 3.4% complications were observed such as perforation, leakage, stenosis and septicemia. After an average follow-up of 4.5 months, 1 in 70 patients revealed an ureteropelvic stricture which was treated with open surgery. The ureterorenoscopy represents an effective and low-risk primary and secondary method for treatment of ureteral stones in stone centers using extracorporeal lithotriptors which are exclusively equipped with ultrasound detection devices.