Category: Clinical Stones: Ureteroscopy

MP32-4 - Efficacy and safety of ureteroscopic lithotripsy for the management of impacted ureteral stones

Sun, Sep 23
2:00 PM - 4:00 PM

Introduction & Objective :

Ureteroscopic lithotripsy (URSL) is a standard surgical option for ureteral stones with high success and low complication rates. Impacted ureteral stones, which are fixed in the ureteral lumen, inducing complete ureteral obstrution, have been known to be difficult to be managed even with URSL. However, with the recent advancement of instruments and surgical technique of URSL, improved success and less complications of URSL for impacted ureteral stones are expected. We analyzed surgical outcomes of URSL for impacted ureteral stones.


Methods :

From January 2011 to December 2016, a total of 245 patients underwent URSL by a single surgeon. Impacted ureteral stone was defined as the ureteral stone causing complete ureteral obstruction, which the guide wire cannot pass beside the stone during URSL. We retrospectively reviewed medical records and compared surgical outcomes, including success rates and complications, between impacted ureteral stone group and the other group.


Results :

Of 245 cases, impacted ureteral stones were 55 cases (22.5%), and there were no significant differences in preoperative patients’ characteristics between the two groups. Meanwhile, significantly larger stone size (8.4 vs 11.8 mm, p<0.001), higher hounsfield units (816.7 vs 1052.0, p<0.001), and longer operation time (50.9 vs 68.0 min, p<0.001) were observed in impacted stone group. Although the rate of holmium laser usage as lithotriptor (40.0 vs 63.6%, p=0.002) was higher in impacted stone group, the rate of anti-retropulsion device usage, such as stone basket (90.5 vs 94.5%, p=0.348), complication rate (14.2 vs 18.2%, p=0.469) and stone free rate (91.6 vs 89.1%, p=0.570) were not significantly different between the two groups<./p>


Conclusions :

The results of this study showed that URSL for Impacted ureteral stones tends to need longer operation time due to relatively larger and harder stones. However, URSL can be safely and effectively performed for impacted ureteral stones with proper devices, such as holmium laser and stone basket.

Bum Soo Kim

Assistant professor
Department of Urology, School of Medicine, Kyungpook National University
Daegu, Taegu-jikhalsi, Republic of Korea

Education:
2004 M.D. School of Medicine, Kyungpook National University
2007 M.S. Graduate School of Medicine, Kyungpook National University
(Medical Science/Urology)
2012 Ph.D. Graduate School of Medicine, Kyungpook National University
(Medical Science/Urology)

Postdoctoral Training:

2004-2005 Intern in Medicine, Kyungpook National University Hospital, Daegu, Korea
2005-2009 Resident in Urology, Kyungpook National University Hospital, Daegu, Korea
2013.7 Cleveland Clinic (USA) Medical Observership for Endourology
2016-2017 Visiting scholar in Laboratory of Kidney Regeneration, Jikei University School of Medicine, Tokyo, Japan

Hospital Appointments:

2009.3.1-2010.2.28 Fellow (Urology), Kyungpook National University Hospital
2010.3.1-2014.2.28 Clinical Professor, Kyungpook National University Hospital
2014.3.1-Now Assistant Professor, Kyungpook National University

PROFESSIONAL SOCIETIES

2004 Korean Medical Association, member
2005 Korean Urological Association, member
2009 Korean Prostate Society, member
2010 Korean Endourological Society, member
2014 Urological Association of Asia, member
2014 Korean Endourological Society, deputy general secretary
2016 Korean Endourological Society, a chair of public relations committee
2016 Korean Urological Association, secretary of special committee of policy
2018 Korean Endourological Society, director of international relations and cooperation committee

Kyung Chan Min

Doctor
Department of Urology, School of Medicine, Kyungpook National University
Daegu, Taegu-jikhalsi, Republic of Korea

Jae-Wook Chung

Clinical Professor
Department of Urology, School of Medicine, Kyungpook National University
Daegu, Taegu-jikhalsi, Republic of Korea

Yun-Sok Ha

Clinical Professor
Department of Urology, School of Medicine, Kyungpook National University
Daegu, Taegu-jikhalsi, Republic of Korea

Wonho Jung

Assistant Professor
Department of Urology, School of Medicine, & Institute for Medical Science, Keimyung University, Daegu, Korea
Daegu, Taegu-jikhalsi, Republic of Korea

So Young Chun

Investigative Professor
BioMedical Research Center, Kyungpook National University Hospital
Daegu, Taegu-jikhalsi, Republic of Korea

Seock Hwan Choi

Assistant Professor
Department of Urology, School of Medicine, Kyungpook National University
Daegu, Taegu-jikhalsi, Republic of Korea

Jun Nyung Lee

Assistant Professor
Department of Urology, School of Medicine, Kyungpook National University
Daegu, Taegu-jikhalsi, Republic of Korea

Hyun Tae Kim

Associate Professor
Department of Urology, School of Medicine, Kyungpook National University
Daegu, Taegu-jikhalsi, Republic of Korea

Tae-Hwan Kim

Associate Professor
Department of Urology, School of Medicine, Kyungpook National University
Daegu, Taegu-jikhalsi, Republic of Korea

Eun Sang Yoo

Associate Professor
Department of Urology, School of Medicine, Kyungpook National University
Daegu, Taegu-jikhalsi, Republic of Korea

Tae Gyun Kwon

Professor
Department of Urology, School of Medicine, Kyungpook National University
Daegu, Taegu-jikhalsi, Republic of Korea

Sung Kwang Chung

Professor
Department of Urology, School of Medicine, Kyungpook National University
Daegu, Taegu-jikhalsi, Republic of Korea