1Department of Urology, the Second Surgery Department, the 11th Hospital of PLA, Yining 835000, China; 2The 1st Internal Medicine, the 11th Hospital of PLA
Abstract：Objective: To investigate and improve the diagnosis and treatment of distal ureteral calculi. Methods: The clinical data of 486 cases of distal ureteral calculi from Sep. 2007 to July 2014 in our hospital were analyzed retrospectively, including 282 cases treated by medication firstly, and 204 cases treated by ureteroscopic lithotripsy or ureteral meatotomy firstly. The outcomes were measured with rate of stone clearance, time of caluli expulsion, successful rate of operation, operation time and hospital stay after operation in patients. Adverse effects were recorded. Results: The rate of stone clearance was 78.9% (220/282 cases) in patients who underwent medication, and the mean time of caluli expulsion was (9.6±3.8) days. The rate of stone clearance was 88.0% (139/158) in patients with the diameter of distal ureteral calculi being under 8 mm, and 65.3% (81/124) in the patients with the diameter of distal ureteral calculi being larger than 8 mm (P=0.000). Of all the 266 cases undergoing surgical operation, the successful rate was 100%. The operation time was 13.78 min (mean 39.2±13.4 min), and the hospital stay after operation was 1.8 d (mean 4.1±1.7 d). The incidence of postoperative complications was 1.9% (5/266 cases). The patients were followed up for 1 to 83 months, and no long-term complications such as regurgitation or stenosis of the ureter occurred. Conclusions: Medication is a good choice for the treatment of the distal ureteral calculi (≤8 mm). Ureteroscopic lithotripsy is safe and efficiency for the treatment of the distal ureteral calculi (>8 mm). Transurethral ureteral meatotomy is an optimal treatment for the patients with difficulties in the ureteroscope insertion.
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