Ultrasound-guided minimally invasive percutaneous nephrolithotomy in the treatment of upper ureteral calculi

Aim To investigate the clinical application value and method of ultrasound-guided minimally invasive percutaneous nephrolithotomy(MPCNL) in the treatment of upper ureteral calculi.Methods Twenty-one patients with upper ureteral calculi received minimally invasive percutaneous renal puncture and ureteroscopic lithotripsy under the guidance of ultrasound.Twelve male,9 female,Mean patient age was 45.6 years(18~57 years).The calculi located in the left upper ureter were 11 cases,10 in the right.Combined with ipsilateral renal calculus were in 8 cases,one patient associated with ureteral stricture,intermediate hydrops in 9 cases,severe hydrops in 6 cases.Mean stone size was 16 mm(10~30 mm)in diameter.Results All the patients were punctured successfully at one prick and twenty patients with upper ureteral calculi were removed out through single passage in phrase I.Operative duration was 60~150 min.The total stone clearance rate was 95.2%.Residual stone fragment was found in 1 patient,then discharged one week later after pull out D-J tube.No serious complications occurred in the operation.Conclusion Ultrasound-guided minimally invasive percutaneous nephrolithotomy is a safe and effective technique for the treatment of upper ureteral calculi or associated with ipsilateral renal calculus or ureteral stricture with the advantages of little trauma and rapid recovery.Meanwhile,ipsilateral renal calculus and ureteral stricture can also be treated effectively.