Objective: To evaluate retrospectively the results and complication, efficacy, and safety rates of laparoscopic
ureterolithotomy in the treatment of large, impacted ureteric stones.
Materials and Methods: Between September 1994 and December 2003, 73 patients underwent 75
laparoscopic ureterolithotomies (LUL). Mid- and upper-ureteric stones were removed retroperitoneally
in 69 cases (92%). Lower ureteric stones were removed transperitoneally in 6 cases (8%).
There were 2 (3%) bilateral LULs in one session, 7 (10%) ipsilateral percutaneous nephrolithotomy,
and 6 (8%) ipsilateral ureteroscopy in the same session. The mean age of the patients was 39
years (range, 15–70 years). Mean stone size was 25 mm (range, 12–55 mm).
Results: The success rate was 98.7%, with 1 patient (1.3%) requiring conversion to an open procedure.
There were no major complications. Mean operative time was 45 minutes (range, 15–100
minutes). Postoperative analgesic medication was required for 1 day in 39 patients (52%). The postoperative
hospital stay ranged from 2 to 5 days (mean, 3 days).
Conclusion: On the basis of our experience, laparoscopic ureterolithotomy is a safe and effective
method for the treatment of large, dense, and impacted ureteric stones. In selected cases it can be
the first choice of treatment.
