PERCUTANEOUS EXTRACTION OF RENAL AND URETERAL STONES: REVIEW OF 125 CASES

We describe 125 cases of a percutaneous approach to stones at our hospital for the 2 years between June 1984 and July 1986. As a rule, we performed these procedures in one session, but, several procedures were necessary in 34 cases. Open surgery was performed on 11 cases (in 5 cases firmly impacted ureteral stones could not be extracted, in other 5 cases nephrostomy construction failed and in the last one case nephroscope deviated from the nephrostomy tract in the procedure). Although residual stones were found in 15 cases (9-caliceal stones and 6-small stones), target stones were successfully treated in all cases. We described in the first report that some ureteral stones could not be treated by percutaneous approach when they firmly impacted in the ureter. In our series, however, ureteral stone patients occupied 71 of the 125 cases. Therefore, it was very important how to extract ureteral stones. Thirty-two ureteral stones were easily moved into the renal pelvis (in 12, by only ureteral catheterization and in 20, by flushing through the ureteral catheter). But, because stones were firmly impacted in other 39 cases (basket catheter or other forceps was used in 29 cases and ultrasound destruction was done in 10 cases). Before the use of the ureterorenoscope, we performed open surgery to extract firmly impacted ureteral stones. But we have become to be able to extract such a stone, using the ureterorenoscope through the nephrostomy tract.