Laparoscopic management of distal ureteric stones in a bilharzial ureter: Results of a single-centre prospective study

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Nour H.H.; Elgobashy S.E.; Elkholy A.; Kamal A.M.; Roshdy M.A.; Elbaz A.G.; Riad E.

Journal: Arab Journal of Urology

Publisher: Arab Association of Urology

Publication Date: 5 April 2019

Volume / Issue: Volume 13 / Issue 3

Pages: 182–186

Article No.: 306

ISSN: 2090598X

DOI: 10.1016/j.aju.2015.06.006

Scopus: View on Scopus

Document Type: Article

Access: All Open Access; Gold Open Access; Green Open Access

Authors and Affiliations

Nour H.H., Urology Department, Theodor Bilharz Research Institute, Giza, Egypt; Elgobashy S.E., Urology Department, Theodor Bilharz Research Institute, Giza, Egypt; Elkholy A., Urology Department, Theodor Bilharz Research Institute, Giza, Egypt; Kamal A.M., Urology Department, Theodor Bilharz Research Institute, Giza, Egypt; Roshdy M.A., Urology Department, Theodor Bilharz Research Institute, Giza, Egypt; Elbaz A.G., Urology Department, Theodor Bilharz Research Institute, Giza, Egypt; Riad E., Urology Department, Theodor Bilharz Research Institute, Giza, Egypt

Abstract

Objective To determine the efficacy and safety of the laparoscopic management of an impacted distal ureteric stone in a bilharzial ureter, as bilharzial ureters are complicated by distal stricture caused by the precipitation of bilharzial ova in the distal ureter. These cases are associated with poorly functioning and grossly hydronephrotic kidneys that hinder the endoscopic manipulation of the coexistent distal high burden of, and long-standing, impacted stones. Patients and methods We used laparoscopic ureterolithotomy, with four trocars, to manage 51 bilharzial patients (33 men and 18 women; mean age 40.13 years) with distal ureteric stones. The ureter was opened directly over the stone and the stone was extracted. A JJ stent was inserted into the ureter, which was then closed with a 4-0 polyglactin running suture. Results The mean stone size was 2.73 cm. Conversion to open surgery was required in only one patient. The mean operative duration was 92 min, the postoperative pain score was 20-60, the mean (range) number of analgesic requests after surgery was 1.72 (1-3), comprising once in 21 patients, twice in 23 and thrice in seven. The mean hospital stay was 2.74 days, and the total duration of follow-up was 7-12 months. The stone recurred in four patients and a ureteric stricture was reported in two. All patients were rendered stone-free. Conclusion Laparoscopy is a safe and effective minimally invasive procedure for distal ureteric stones in a bilharzial ureter with hydronephrosis. © 2015 Production and hosting by Elsevier B.V.

Keywords

Bilharzial ureter; Laparoscopy; Stone; Transperitoneal; adult; Article; conversion to open surgery; double J stent; female; human; hydronephrosis; laparoscopic surgery; laparoscopic ureterolithotomy; length of stay; major clinical study; male; minimally invasive procedure; operation duration; operative blood loss; patient safety; postoperative pain; prospective study; recurrent disease; schistosomiasis; ureter disease; ureter stone; ureterolithotomy

Citation Information

Scopus Citations: 4

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