Ureteroscopy Outcome and Its Determinants in a Resource-Limited Setting

Abstract

Background: Ureteroscopy is a major diagnostic and therapeutic technique for lesions of the ureter and intrarenal collecting system. Methods: A retrospective chart review was done at St. Paul’s Hospital Millennium Medical College, Ethiopia to determine the outcome of  ureteroscopy and factors affecting it. The study period was from January 2018 to April 2018. Multivariate analysis was done to determine factors  affecting stone clearance and success rate. Result: One hundred six patients who underwent semirigid ureteroscopy were included in the study. The male-to-female ratio was 1.8:1. The mean  age of the patients was 36.4 years (±12.6). Ninety-six (90.6%) patients were found to have ureteric stones, while 9(8.5%) patients had a ureteric  stricture. Ureteroscopy therapeutic interventions for stones were successful in 89 (92.7%) patients. The mean procedure time and postoperative  hospital stay were 44 minutes (±23.7) and 2.5 days (±2.5) respectively. Intraoperative complications (ureteric avulsion, hemorrhage, and ureteral  perforations) occurred in 6(5.7%) patients. The stone clearance rate was 54.7% (52). The site of obstruction was passed in 93 patients making the  success rate of the procedure 87.7%. The absence of intraoperative complications was significantly associated with success rate. Patients with  intraoperative complications have low success rate (20%) compared to patients without complications (92.3%), p=0.42. Conclusion: Semirigid  ureteroscopy had a good success rate, especially for stones in the distal ureter and if there is no flexible ureteroscope, it is an acceptable alternative.