Efficacy of laparoscopic ureterolithotomy for the upper ureter stone

Purpose: Ureter stones are the most common urological disease. The principal objective of this study was to evaluate the results, efficacy, and safety rates of laparoscopic ureterolithotomy for the treatment of large, upper ureteral stones. Materials and Methods: Between April 2006 and February 2008, we conducted laparoscopic ureterolithotomy in 7 patients with upper ureter stones (L2-3). Laparoscopic ureterolithotomy was conducted in 5 patients as a salvage procedure after failed shock wave lithotripsy, in 1 patient as the primary procedure for a large stone (28mm), and in 1 patient for treatment of a radiolucent matrix stone. Laparoscopic ureterolithotomy was conducted via a transperitoneal approach. The mean stone size was 20.7±5.9mm. Results: Laparoscopic ureterolithotomy was successful in 7 patients, and none of the patients required an open procedure. All patients were rendered stone-free after a single procedure. The mean operative duration, mean postoperative hospital stay, and mean estimated blood loss were 142±49 min, 6±2.2 days and 85±29.5ml, respectively. Conclusions: Although the majority of patients with ureter stones can be rendered stone-free via shock wave lithotripsy and endourological procedures, open surgery is required for large and upper ureter stones. In cases of large and upper ureter stones, laparoscopic ureterolithotomy may be considered for a limited group, although many will require open surgery.