Ureteroscopia : 15 años de experiencia. Comentario

The above presents the experience gathered throughout 15 years performing rigid ureteroscopy, mainly applied to the treatment of ureteral lithiasis and in less proportions to other indications as well. In order to make this presentation an homogeneous one, only off-the-hospital cases were considered for the statistics. A total number of 335 ureteroscopies were performed out of 320 patients, of which 312 (93.1%) corresponded to lithiasis; 3 (0.89%) to investigation of criptogenic unilateral hematuria; 2 (0.59%) to biopsies of urothelium tumors; 2 (0.59%) to the removal of lost catheters and 1 (0.29%) to retrogressive treatment of ureteropyelic stenosis. This is a procedure with low hospitalization (1.25 days average) and of high effectiveness in the treatment of ureteral lithiasis with a 90.77% success. The most frequent intraoperatory complications were: impossibility to find (0.59%) perform dilation of the ureteral meatus, undesired ascension of stone to the kidney (2.56%), extraperitoneal perforation of the ureter (1,60%). During the immediate postoperative period it produced pain, body temperature and hematuria, which disappeared within few hours with adequate treatment. No long-term after surgery complications are registered in any cases which had had an adequate follow-up, as quoted in literature by other authors such as narrowness of meatus or the appearance of vesicoureteral reflux. The conversion index to open surgery of the treated lithiasis was of a 3.52% and it was used as rescue treatment after failure of shock-waves in 9.29% of cases. A wise and careful use of this procedure is followed by low morbidity, due to which this has become a definitively incorporated resource to the urological armament.