Emergent ureteroscopic management of ureteral calculi for patients with pyelonephritis owing to stone impaction

• Published in: Japanese Journal of Endourology Vol. 26; no. 1; pp. 121 - 125
• Main Authors: Kimura, Motohiko, Shimura, Hisanobu
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Endourology 2013; 日本泌尿器内視鏡学会
• Subjects: TUL; 結石性腎盂腎炎; 緊急手術
• ISSN: 2186-1889; 2187-4700
• DOI: 10.11302/jsejje.26.121

For patients with pyelonephritis owing to ureteral obstruction by stone impaction, in general, the initial treatment is antibiotic administration and drainage of the upper urinary tract. Recently, we treated 14 patients by emergent ureteroscopic lithotripsy （URS）. Selection criteria for emergent URS were： stability of the systolic blood pressure （over 100 mmHg）, absence of tachypnea, non-severe DIC, an 8-mm or smaller stone diameter, and a middle or lower ureteral stone. Stone fragmentation, removal, and the indwelling of ureteral stents were performed in all 14 patients. There was no postoperative exacerbation of the clinical condition. The stone-free rate was 100%. The average operation time and periods down to less than 38℃ were 54 minutes and 1.4 days, respectively. The median period of hospitalization was 8 days. Our results show that emergent URS management for pyelonephritis associated with ureteral stone obstruction can be safely and successfully performed under selected clinical conditions.