OUTCOME OF ENDOSCOPIC TREATMENT OF LOWER URETERIC PATHOLOGY

Abstract

The indications for ureteroscopy have broadened from diagnostic endoscopy to a variety of minimally invasive therapies. Endoscopic lithotripsy, treatment of upper urinary tract urothelial malignancies, incising • strictures, and repairing UPJ obstructions all are current treatments facilitated by contemporary ureteroscopic technjques.

With this progression of ureteroscopic procedures from diagnostic to now complex therapeutic interventions, one would expect a proportional increase in rate and severity of complications. However, with improved instrumentation and an evolution of surgical technique, the complication rate with ureteroscopy actually has decreased significantly.

At the beginning we reviewed the surgical and endoscopic anatomy of the ureter. The history and development of the ureteroscope, the ureteroscope design and the working instruments that can be used through it, all were reviewed in some details. The indications and the technique of ureteroscopy were also presented. Finally we reviewed the difficulties during ureteroscopy and the intraoperative and postoperative complications.