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Outcome of Transperitoneal Laparoscopic Ureterolithotomy (TPLU) for proximal ureteral stone > 15 mm: Our experience with 60 cases

Authors

Ali Eslahi
Department of Urology, School of medicine, Shiraz University of Medical Sciences, Shiraz; Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of.
Faisal Ahmed
fmaaa2006@yahoo.com
https://orcid.org/0000-0001-7188-2715
Urology research center, Al-Thora hospital, Department of Urology, Ibb University of Medical Since, Ibb, Yemen.
Mohammad Rahimi
Department of Urology, School of medicine, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of.
Seyed Hamed Jafari
https://orcid.org/0000-0001-5364-2566
Medical Imagining Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of.
Seyyed Hossein Hosseini
Department of Urology, School of medicine, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of.
Saleh Al-wageeh
Department of General Surgery, Ibb University of Medical Science, Ibb, Yemen.
Pegah Mohammad Zadeh Shirazi
Department of Urology, School of medicine, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of.
Khalil Al-naggar
Urology research center, Al-Thora hospital, Department of Urology, Ibb University of Medical Since, Ibb, Yemen.
Ebrahim Al-shami
https://orcid.org/0000-0002-4513-9562
Urology research center, Al-Thora hospital, Department of Urology, Ibb University of Medical Since, Ibb, Yemen.
Mohammad Hossein Taghrir
Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of.

Purpose: We aim to review our experience of transperitoneal laparoscopic ureterolithotomy (TPLU) for proximal ureteric stone more than 15 mm.
Patients and methods: Between June 2017 to December 2020, sixty patients with a history of unsuccessful Extracorporeal shock wave lithotripsy (ESWL) and/or failed ureteroscopy for impacted ureteral calculi more than 15 mm who accepted TPLU were enrolled in our study. The patients' demographic information and post-treatment results were gathered and analyzed, retrospectively.
Results: The patients' mean age was 46.25 ± 12.56 years. The mean size of the stone was 20.11 ± 4.76 mm. 37 (61.7%) patients had severe hydronephrosis (HDN) and 46 (76.7%) stones were radio-opaque. Almost all of the patients underwent TPLU by a single urologist. The mean operation time was 72.86 ± 6.07 minutes without intraoperative complication (only 3 stones had upward migration to the pyelocaliceal system). The main operative blood loss was 88.86 ml. The average length of stay in the hospital was 45.8 ± 8.11 hours. The stone free rate (SFR) at discharge was 57 (95%). The overall complication rate was 27 (45%). Regarding early complications, fever was found in 8 (13.3%) patients, and 3 patients (5%) had paralytic ileus. The rate of urine leak was 8.3%, and 8 (13.3%) patients required blood transfusions. In multivariate analysis, the multiple stones, bigger stone in size, incomplete SFR, longer duration of hospital admission, and severe HDN were associated with a high early complication rate (p = 0.05, 0.04, < 001, 0.03, and 0.01, respectively).
Conclusions: TPLU is a harmless option for managing proximal ureteric stone as a primary procedure or salvage procedure with good outcomes and acceptable complication rates.

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How to Cite

Eslahi, A. ., Ahmed, F. ., Rahimi, M. ., Jafari, S. H., Hosseini, S. H. ., Al-wageeh, S. ., Shirazi, P. M. Z. ., Al-naggar, K. ., Al-shami , E. ., & Taghrir, M. H. . (2021). Outcome of Transperitoneal Laparoscopic Ureterolithotomy (TPLU) for proximal ureteral stone > 15 mm: Our experience with 60 cases. Archivio Italiano Di Urologia E Andrologia, 93(3), 330–335. https://doi.org/10.4081/aiua.2021.3.330

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