Paraureteral calculi caused by ureteroscopic perforation.

OBJECTIVES

Ureteroscopy has become an effective and safe procedure for treatment of ureteral calculi. Formation of strictures are considered long-term complications with a low incidence. This report focuses on the incidence of strictures in cases of calculi pushed or flushed retroperitoneally alongside the ureter because of iatrogenic ureteral perforation.

METHODS

Fifteen consecutive patients with paraureteral calculi caused by ureteroscopic perforation were observed. An excretory urogram was performed after a mean of 22.5 months, with a range of 9 to 54 months. In all patients, a stent was placed for 3 to 41 days (mean, 13.5 days) and antibiotics were administered between 3 and 5 days postoperatively.

RESULTS

Only 1 patient of 15 with a short stricture of the distal ureter was observed. The stricture was successfully treated by endoscopic ureterotomy, balloon dilation, and transient placement of a ureteral stent.

CONCLUSIONS

Paraureteral calculi caused by ureteral perforation are a minor complication of ureteroscopy, which rarely lead to formation of strictures. Removal of paraureteral calculi by enhanced endoscopic procedures or open surgery is not required.