Vol. 6, Issue 1, Part A (2024)

Background: There are many surgical options for the management of impacted upper ureteric stones. The durations as well as the degree to which the calculus is impacted result in renal function derangement. Surgical options include Extracorporeal shockwave lithotripsy (ESWL), PCNL, open and laparoscopic surgeries. The aim of the study to evalute the efficacy & safety of in situ management of impacted upper ureteric stone with mini- percutaneous nephrolithotomy.
Methods: This was a prospective study and was conducted in Chevron Specialized Hospital in Chattogram from July 2020 to January 2023. A total of 40 patients were included in this study. All patient underwent prone mini PCNL, with 15Fr amplatz sheath with fluoroscope guided access. Stones fragmented by holmium laser.
Results: The mean age (in years) of patients was 44.5 and range 22-62, the male female ratio was 28:12. The mean stone size was 17.5 mm. The disease laterity (left: right) was 24:16. The mean procedure time was 65.9 minutes. Hydronephrosis appeared in all paitents, but the renal units were functional. 85% paitents were discharged on within next post-operative day. After one month of follow-up the stone free rate was 95.5% while as the stone free rate on discharge was 87.8%. Complication rate was 12% which include post operative fever, pain, prolonged hematuria and mild thoracic complication. Residual stone found in three paitent after four weeks follow-up. No hollow visceral Perforation and no ureteral injurey was noted.
Conclusions: We conclude here in situ mini-PCNL is safe and effective procidure for impacted upper ureteric stone. So, it can be done with higher success, good stone clearance & with minimal complication.