Role of dilatation of intramural ureter in patients with lower urinary tract symptoms (LUTS) in UVJ and pre UVJ calculus: an observational study

Narasimhaiah Krishnappa; Asif Khan; Saraswathi Sakranaik

doi:10.18203/2349-2902.isj20175896

Authors

Narasimhaiah Krishnappa Department of Surgery, Adichunchanagiri Institute of Medical Sciences, BG Nagara, Bangalore, Karnataka, India
Asif Khan Department of Community Medicine, Quassim University, Kingdom of Saudi Arabia, Adichunchanagiri Institute of Medical Sciences, BG Nagara, Bangalore, Karnataka, India
Saraswathi Sakranaik Department of Community Medicine, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-2902.isj20175896

Keywords:

Dilators UVJ, LUTS, Pre UVJ calculi, URSL

Abstract

Background: Various literature sources describe three narrowest anatomic spots in the ureter as the most potential points for ureteric calculi to form and these are: the pelvi-ureteric junction (PUJ), the point where the ureters cross over the iliac vessels and the ureterovesical junction (UVJ).

Methods: This study included patients who presented with symptomatic obstructing ureteric calculi and who required uretero renoscopic lithotripsy (URSL). The procedure was selected according to stone size, location and degree of impaction.

Results: Of the total of 100 patients, 43 were females and 57 were males. 69 patients had Lower Urinary Tract Symptoms and 31 patients had no Lower Urinary Tract Symptoms with the calculi. The age of the patients ranged from 17 years to 65 years and the stone size ranged from 7mm to 15mm. Lower ureteric calculi with LUTS are good indicators.

Conclusions: We can approach lower ureteric calculi without use of dilators or 6/7.5ureteroscope in patients with LUTS.

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References

Finlayson B, Ackermann D. Overview of surgical treatment of urolithiasis with special reference to lithotripsy. J Urol. 1989 Mar;141(3 Pt 2):778-9.

Eisenberger F, Fuchs G, Miller K. Extracorporeal shockwave lithotripsy (ESWL) and endourology: An ideal combination for the treatment of kidney stones. World J Urol. 1985;3:41-7.

El-Barky E, Ali Y, Sahsah M, Terra AA, Kehinde EO. Site of impaction of ureteric calculi requiring surgical intervention. Urolithiasis. 2014;42(1):67-73.

Bader MJ, Eisner B, Porpiglia F, Preminger GM, Tiselius HG. Contemporary management of ureteral stones. European Urol. 2012; 61(4):764-72.

Leijte JA, Oddens JR, Lock TM. Holmium laser lithotripsy for ureteral calculi: predictive factors for complications and success. J Endourol. 2008;22(2):257-60.

Marickar YMF. Epidemiology of Stone Disease in Kerala, South India. In: Talati JJ, Tiselius H-G, Albala DM, Ye Z, editors. Urolithiasis: Basic Science and Clinical Practice. London: Springer London;2012:47-51.

Ordon M, Schuler TD, Ghiculete D, Pace KT, Honey RJDA. Third Place: Stones Lodge at Three Sites of Anatomic Narrowing in the Ureter: Clinical Fact or Fiction? J Endourol. 2013;27(3):270-6.

Papadoukakis S, Stolzenburg J-U, Truss MC. Treatment Strategies of Ureteral Stones. EAU-EBU Update Series. 2006;4(5):184-90.

Segura JW, Preminger GM, Assimos DG, Dretler SP, Kahn RI, Lingeman JE, et al. Ureteral stones clinical guidelines panel summary report on the management of ureteral calculi. J Urol. 1997;158(5):1915-21.

Anagnostou T, Tolley D. Management of Ureteric Stones. European Urol. 2004;45(6):714-21.

Lotan Y, Gettman MT, Roehrborn CG, Cadeddu JA, Pearle MS. Management of ureteral calculi: a cost comparison and decision making analysis. J Urol. 2002;167(4):1621-9.

Sowter SJ, Tolley DA. The management of ureteric colic. Curr Opin Urol. 2006;16(2):71-6.

Ramesh A, Karthick P, Shiva KR. Medical expulsion therapy for ureteric calculus - possible!. ISJ. 2016 Dec 13;3(1):113-8.

Marshall LS. Urinary stones disease. In: Amend WJ Jr, Barbour S, Baskin LS, Berger TG, Bloom AL, Bretan PN Jr, et al editors. Smith's Urology. New York: McGraw Hill; 2004:256-290.

Ueno A, Kawamura T, Ogaa A, Takayasu H. Relation of spontaneous passage of ureteral calculi to size. Urology. 1977 Dec;10(6):544-6.

Miller OF, Kane CJ. Time to stone passage for observed ureteral calculi: a guide for patient education. J Urol. 1999 Sep;162(3 Pt 1):688-90.

Ordon M, Andonian S, Blew B, Schuler T, Chew B, Pace KT. CUA Guideline: Management of ureteral calculi. Canadian Urol Assoc J. 2015;9(11-12):E837-E851.

Song H-J, Cho S-T, Kim K-K. Investigation of the Location of the Ureteral Stone and Diameter of the Ureter in Patients with Renal Colic. Korean J Urol. 2010;51(3):198-201.

Jellison FC, Smith JC, Heldt JP, Spengler NM, Nicolay LI, Ruckle HC, et al. Effect of low dose radiation computerized tomography protocols on distal ureteral calculus detection. J Urol. 2009 Dec;182(6):2762-7.