Ureteral meatotomy by endoscopic knife electrode in the management of large stones impacted in the intramural ureter

ABSTRACT

Transurethral meatotomy with knife electrode or Collings ' knife was done in 18 patients who either had a stone impacted in the intramural ureter and not suitable for ureteroscopic manipulations due to its large size [13] or when the dormia basket became impacted during attempts to extract the stone [5]. The stone was recurrent following open surgery in 10 of the 18 patients. This method resulted in successful endoscopic removal of the stones in all patients. Vesicoureteric reflux was detected in 10 patients at 1 month and in only 3 patients at 3 months. Follow up of these patients revealed no symptomatic upper tract infection or renal damage caused by this reflux. It was concluded that endoscopic ureteral meatotomy is recommended for the removal of impacted intramural ureteric stones not suitable for ureteroscopic manipulations or stones impacted in the dormia basket at the ureteric orifice, especially in recurrent cases