RETROGRADE MANIPULATION FOR PROXIMAL URETERAL STONES BEFORE EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY - TECHNIQUE, OBSERVATIONS AND RESULTS

Objective To determine the factors affecting the success of retrograde manipulation (RM) of upper ureteric stones. Patients and methods A to tal of 601 patients with upper ureteric calculi underwent attempted RM . In 216 patients, RM was performed irrespective of the respiratory ph ase, stone characteristics and ureteric anatomy (group 1). In the rema ining 385 patients RM was performed at the height of expiration (group 2). Patients with large or impacted stones, ureters with a fusiform o r funnel shape appearance on urography and grade IV hydronephrosis wer e not included in group 2. Results The success rate was significantly greater in group 2. The rates of fever and perforation in groups 1 and 2 were 6.9/2.3% and 3.2/0.2% respectively. The incidence of residual fragments was also less in group 2. Conclusion RM at the height of exp iration is associated with a higher success rate and lower complicatio n rate.