Laparoscopic ureterolithotomy. minimally invasive second line treatment

PURPOSE: To describe our experience of 33 laparoscopic ureterolithotomies for large ureteral stones. METHODS: Since February 2004, in our department, 33 patients had undergone laparoscopic ureterolithotomy. Inclusion criteria were failure of SWL andor ureteroscopic treatment. Stones were located in the lower ureter in 9 patients, in the mid ureter in 16 patients, and in the upper ureter in 8 patients. RESULTS: Mean age of the patients was 47 years (range 37-51). The mean stone size, at preoperative IVP, was 34 mm (range 18-55). All stones were impacted from 4 to 36 months before procedure. Successful rates were 100%. No conversion to open surgery occurred. No intraoperative and postoperative complications occurred. Mean operating time was 85 min (range 60-160). Mean intraoperative blood loss was 70 ml (range 30-120). Mean hospital stay was 3.4 days (range 2-7). Mean follow-up was 24 months (range 6-44). During follow-up, no major complications were observed in any patients. CONCLUSIONS: In our hand, first-line treatment after failure of SWL and or ureteroscopy is laparoscopic ureterolithotomy. Large stone size and previous open surgery did not affect the successful rates of laparoscopic ureterolithotomy.