ABSTRACT
Objective: To ascertain patient's safety and efficacy of ureterolithotripsy as a day-surgery procedure
Study Design: An interventional study
Place And Duration: At Citi Medical Center Larkana, Ghulam Mohammed Mahar Medical College and Hospital Sukkur Peoples University of Medical and Health Sciences for Women Nawabshah between Dec: 2007 to Dec: 2012
Methodology: All the patients of either sex having ureteral stone less than 1.5 cm in diameter were selected on the basis of routine clinical examination, laboratory investigation like complete blood count and biochemistry, Ultra-sound and x-rays like intravenous urography [IVU] etc for ureteral lithotripsy. The Semi-rigid UreteroscopicG.O Fr with Swiss Lithoclast lithotripter was used
Results: Our study comprises 320 selected patients. Male to female ratio was 1.6:1. Average age of patients was 30.5 year. The mean stone diameter was 1.2 cm. The stones were successfully disintegrated and completely pulverized in 95% [n=304] cases. In remaining 5%[n=16] cases, the procedure was deferred. Among them, ureteric catheter or J J stent in 3% [n=9] and 2%[n=7] cases respectively had been left. Of them, former cases were due to failure of access to stone and ureteroscope did not negotiate at all and in later cases stone was presented in upper ureter and inadvertently floated up into the kidney [P< 0.05]. The operative complications like simple mucosal injury occurred in 11%[n=35] and minor bleeding which did not cloud the field of vision occurred only in 13%[n=42] cases. The Mean operating time was 27[ranged from 22 to 55] minutes. Postoperative complications like urinary tract infection [sepsis] with fever and persisting haematuria had occurs in 5.5%[n=18] cases 9%[n=29] respectfully. The hospital stay was merely a day in all except 15% [n=47] cases who developed post-operative complications [P< 0.05]. In 03 week follow-up, residual fragments were noted only in 6%[n=19] cases. These patients were managed conservatively except 2%[n=7] cases that underwent repeat ureteral catheterization for manipulation of fragments which were jammed together, remit
Conclusion: Although, our study has documented high success rate and low morbidity with merely a day hospital stay but is dependent on many potentially modifiable and process-related factors