Treatment and prevention of complication of rigid ureteroscopy

[Objective] To study the cause and prevention of complication of rigid ureteroscopy. [Methods] Between October 1991 and June 2004, 804 patients were performed ureteroscopy. A retrospective review of complications with those patients was conducted. [Results] Injured to ureteral orific happened in 59 cases, severe avulsion of ureteral orific in 12 cases (1.49%), ureteral perforation in 14 cases (1.74%), Ureteral perforation in 14 cases (1.74%), incarcerated ureteroscope in 7 cases (0.87%), homorrhage in 10 cases (1.24%), Severe avulsion of ureteral menberane not happened in those patients, transform operation needed in 2 cases. ESWL was needed in 96 cases, secondary ureteroscopy in 47 cases after first ureteroscopy. Followup imaging with renal ultrosound and excretory urography at 3 months to 23 months after ureteroscopic procedure was available in 524 cases and showed ureteral orific delayed stricture in 5 cases (0.95%), ureteral stricture in 8 cases (1.53%). Balloon dilation of ureteral stricture was operated, ureterovesial anastomosis in 2 cases, ureter-ureteral anastomosis in 4 cases. All patients with complication were cured or improved by different means. [Conclusions] We must pay great attention to severe complication of ureteroscopy. Most complication of ureteroscopy can be prevented with correct methods.