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Objective. Аnalysis of the treatment results in patients, suffering ureteric calculi, using the contact ureterolithotripsy procedure. Маterials and methods. In 104 patients with ureteric calculi, in whom ureteroscopy with further laser contact ureterolithotripsy was conducted, symptoms of the disease were analyzed, as well as the diagnostic methods value, peculiarities and efficacy of surgical treatment. Results. In all the patients endoscopic extraction of calculi have been succeeded. Calculus does not cause significant macroscopic changes in ureter, if symptoms, characteristic for ureterolithiasis, persists up to one week. Local edema is formed, if a calculus persists in ureter longer than a week. Long-term (more than two months) local ureteric persistence of calculi enhances the risk of its intramucosal intraureteric «ingrowth» greatly. Conclusion. The contact ureterolithotripsy constitutes a highly effective and miniinvasive method of surgical intervention in ureterolithiasis, guaranteeing high level of postoperative “stone free rate”. Prolongation of the calculi ureteric insertion time without a process of a stone discharge causes the ureteric wall changes, complicating performance of miniinvasive interventions (the contact ureterolithotripsy and a distant shock-wave lithotripsy).

Aim: To assess the efficacy and safety of two different techniques (Percutaneous nephrolithotomy (PNL) vs Retrograde intrarenal surgery (RIRS)) in the management of stones in patients with horseshoe kidneys (HSK). Patients and methods: Departmental files of 88 cases with radiopaque kidney stones in horseshoe kidneys undergoing two different approaches (PNL vs RIRS) were evaluated with respect to the success and complication rates of in a retrospective manner. In addition to the factors related with the procedures (success and complication rates, additional procedures), patient and stone characteristics were all well evaluated. Findings obtained in both groups were evaluated in a comparative manner with respect to the statistical significance. Results: Stone free rates were comparable in both groups after 1-week period (81.6% PNL vs 80% RIRS). As well as 3 months evaluation (84.2% PNL and 82.0% RIRS). The percentage of the cases with residual fragments (> 4 mm) were similar in both groups and while all PNL procedures were completed in one session, mean number of RIRS sessions was higher (1.22 ± 0.05). Mean duration of the procedure was slightly higher in RIRS group and based on Clavien scoring system, despite a higher risk of Hb drop noted in patients treated with PNL, all complication rates were found to be similar in both groups. Conclusion: Our results demonstrate that of the available minimally invasive treatment alternatives, both PNL and RIRS could be safe and effective alternatives for renal stone removal in patients with HSK.

Objectives: To determine the causes of steinstrasse and to assess the success of primary ureteroscopic removal using pneumatic lithotripsy. Methods: Three hundred and two patients with urinary stones (242 renal and 60 ureteric) underwent extracor-poreal shock wave lithotripsy treatment using Stonelith electrohydraulic lithotripter from June 1999 to July 2002 in the Department of Urology, Institute of Medical Sci-ences, Banaras Hindu University. Of these, 29(9.6%) de-veloped steinstrasse. There were 23 males and 6 females in the age group of 24-66 years. After ESWL the patients were followed weekly using plain films and ultrasonogra-phy for the 1 st month and thereafter monthly for 2 months. Their radiological appearance was classified into 3 types. Majority of the patients developing steinstrasse had a stone size of 2-3 cm and most of the steinstrasse was found in the lower ureter usually after 6001-9000 shocks at a mean power of> 16 kv. The length of the steinstrasse was 3-4 cm in the majority of patients. Results: Conservative management was successful in 15 patients (51.7%); repeated ESWL in 4 (13.8%). Ureteroscopic removal using pneumatic lithotripsy under i/v sedation was successful in 10(34.5%) patients. Conclusions: Large stone burden (>2 cm) and use of high energies (>16 kv) are leading factors responsible for the development of steinstrasse. Ureteroscopic removal using pneumatic lithotripsy is a definitive and predictable treatment modality with a high success rate.