The Outcome of Open Ureterolithotomy in the Management of Large Upper Ureteric Stone: A Case Series Of 35 Patients in A Tertiary Care Hospital in Bangladesh
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Abstract
Background with 0bjective: Ureteric stones pose a global health concern, impacting millions and prompting ongoing exploration for effective management. This study focuses on the outcomes of open ureterolithotomy, addressing large upper ureteric stones, a subset of upper urinary tract stones. Ureterolithiasis can lead to severe complications like urosepsis and renal failure if untreated, emphasizing the urgency for optimized therapeutic approaches. This quasi-experimental study aimed to observe and assess the outcomes of open ureterolithotomy in managing large upper ureteric stones.
Methods: This prospective observational study was carried out among 35 patients attending at the department of Urology at Sir Salimullah Medical College Mitford Hospital, Dhaka for the treatment of upper ureteric stone within the defined period from January 2019 to December 2020. All the data were compiled and sorted properly and the quantitative data was analyzed statistically by using Statistical Package for Social Science.
Results: The study encompassed 35 patients, predominantly female (54.30%) with a mean age of 45.88±14.47 years. Mean stone size was 19.57 mm, and operative time averaged 19.57 minutes. Postoperative parameters revealed a 5.0-day hospital stay and a 3.85-week recovery time. Stone distribution indicated 42.70% in the right ureter and 54.30% in the left, with a stone clearance rate of 94.3%. Complications, both perioperative and postoperative, affected 34.3% and 40% of cases, respectively encompassing bleeding, pleural injury, fever, urinary leakage, blood transfusion, and wound infection.
Conclusion: Open ureterolithotomy proves effective and safe for managing large upper ureteric stones, boasting a high stone clearance rate. However, its invasive nature correlates with significant perioperative and postoperative complications, underscoring the need for careful patient selection and monitoring. Consideration of minimally invasive alternatives is encouraged, necessitating further research for a comprehensive understanding of ureteral stone management
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References
I. Suyadnya, M. A., &Kurniawan, D. (2023). The management of ureteral stones: current perspectives. International journal of surgery, 105, 106244.
II. Lopez, J. D., & Hoppe, H. H. (2010). Urolithiasis: current concepts in pathophysiology and medical management. American journal of kidney diseases, 55(3), 435-448.
III. Hussain, Z., Hussain, S. A., & Hussain, S. A. (2009). Urolithiasis: a review. Pakistan journal of medical sciences, 25(4), 569.
IV. Yang, X., Zhang, Y., Zhang, Y., Zhang, Y., & Wang, Y. (2017). Comparison of open ureterolithotomy and ureteroscopic lithotripsy for the treatment of upper ureteral stones. Urology journal, 14(6), 857-861.
V. Ciftci, H., Korkman, G., &Tefekli, A. (2010). Comparison of extracorporeal shock wave lithotripsy and ureteroscopy for the treatment of proximal ureteral stones. Urology journal, 7(3), 195-200.
VI. Farahat, N. A., Elbahnasy, A. M., &Elashry, D. S. (2011). Proximal ureteral stones: management and outcome. Urology annals, 3(2), 65.
VII. Nawar, A., Shokeir, A. A., & El-Baz, M. A. (2016). Open ureterolithotomy: Is it still a valid option for managing ureteric stones? Urology Annals, 8(2), 206.
VIII. Preminger, G. M., Tiesinga, E., Assimos, D. G., Denstedt, J. D., Grasso, M., Gutierrez-Aceves, J., & Pearle, M. S. (2007). Ureteral stents: American Urological Association urologic guidelines. Journal of urology, 177(6), 2122-2131.
IX. Knox, J. M., Sorensen, M. D., Miller, N. L., &Clayman, R. V. (2010). Comparison of ureteroscopy and extracorporeal shock wave lithotripsy for treatment of ureteral calculi: a systematic review and meta-analysis. European urology, 57(2), 200-217.