Outcome of Semi-Rigid Ureteroscopy with LASER Lithotripsy for Management of Upper Ureteric Calculi

Background: Proximal ureteral calculi are common with multi-modalities of treatment, with continuous invention of new modalities. Aim of the work: To present the early experience with LASER lithotripsy using semi-rigid ureteroscopy for treatment of upper ureteral calculi, regarding safety and efficacy. Patients and Methods:Eighty patients with upper ureteral stones managed by LASER lithotripsy using semi-rigid ureteroscopy were included [30 prospective and 50 retrospective]. Patient evaluation included medical history, clinical examination with preoperative laboratory and radiological investigations. The outcome measure was stone free rate, Intra operative and Postoperative complications, operative time, hospitalization time, and post-operative analgesia. Results: During the period from January 2018 through February 2020 in 30 prospective cases but retrospectively in 50 cases  done in the last two years, 68.8% of patients were males and 31.2% of them were females, mean of age was 43.70 with range from 20 to 66 years, and mean of BMI was 19.75 with range from 18 to 23 with laterality of 60% of patients was right but of 40% was left and stone opacity of 96.25% of patients was radio opaque, while, 3.75% was radio lucent stones the mean operative time was 50.78 minutes and mean duration of hospital stay was 1.3 days. In addition, 66.2% of patient needed JJ, 32.5% required ureteric catheter and 15% failed ESWL. The mean ureteral stone diameter was 10.81. The clearance rate 97.5%; two cases had migrated stone. Conclusion: Semirigid ureteroscope with LASER lithotripsy is an effective and safe procedure for management of large proximal ureteral stones with a lesser rate of stone migration needs use of flexible ureterorenoscopy.