Emergency ureteroscopic management of acute calcular anuria

ABSTRACT

To study the outcome and complications of emergency ureteroscopy in management of acute calcular anuria. 35 patients with calcular anuria were included in the study. The mean age was 45 +/- 18 years with 30 male and 5 females. The diagnosis was based upon anuria associated with high serum creatinine and hydronephrosis detected by ultrasonography. KUB was done to detect radio-opaque stones and its location and size. Emergency ureteroscopy was done to all cases. Bilateral ureteric calculi were detected in 31 patients and unilateral ureteric calculus in 4 patients in whom the other kidney was surgically removed. The stones were localized in the distal ureter in 50 units and in the proximal ureter in 16 units. 60 stones were radio-opaque and 6 stones were radiolucent. The mean stone size was 9 +/- 3mm. The mean serum creatinine was 7.3 +/- 2.5 mg/100 ml. The stone free rate in the proximal ureteric stones was 50% and for the distal ureteric stones was 90%. The overall stone free rate was 80%. No complications were discovered after ureteroscopy to any case. The urine output increased dramatically immediately after treatment in all cases. The serum creatinine dropped to the normal level in all cases [1.2 +/- 0.4 mg/100 ml] in 6.9 +/- 1.8 days after treatment. The mean hospital stay was 2.8 +/- 1.3 days. Emergency ureteroscopy is a safe and an appropriate therapeutic option in the management of acute calcular anuria. It can save patients from a second procedure