Address of Corresponding Author

Urol Int 2005;74:319-322 (DOI: 10.1159/000084430)

  Key Words

• Percutaneous nephrostomy
• Ureteroscopy
• Sepsis
• Ureteral calculi

  Abstract

Introduction: Retrograde decompression is generally not advocated for patients with sepsis owing to ureteral obstruction by stone impaction, and the initial treatment of choice is percutaneous nephrostomy (PCN). We report our experience with the treatment of urosepsis with retrograde ureteroscopy (URS) instead of PCN drainage. Patients and Methods: Fifty-six consecutive patients diagnosed with ureteral stone-related sepsis received URS as primary treatment at our institution. Patients with uncontrollable sepsis underwent emergent URS and hemodynamically stable patients underwent elective URS within two days of diagnosis. Results: URS was successful in 53 (94.6%) of the 56 patients. PCN was performed in the 3 cases of URS failure. Internal ureteral stenting was performed in 48 patients. Secondary procedures were performed in 10 (18.9%) patients. Twenty-six patients suffered from postoperative fever for an average of 1.6 days (range 1-4 days). There were no anesthesia-related morbidities, postoperative exacerbations of the clinical condition, or postoperative deaths. The median length of hospital stay was 7 days (range 3-94 days). Conclusion: PCN drainage is the standard treatment of sepsis associated with ureteral stone obstruction. However, our results show that URS can be safely and successfully performed by skilled endourologists in select clinical situations.

Copyright © 2005 S. Karger AG, Basel

  Author Contacts

Stone Yang, MD
Department of Urology, Mackay Memorial Hospital
92, Section 2, Chungshan North Road, Taipei 104 (Taiwan)
Tel. +886 2 2543 3535, ext. 2561, Fax +886 2 2937 1079
E-Mail mchen4270@yahoo.com

  Article Information

Received: October 22, 2004
Accepted: December 16, 2004
Number of Print Pages : 4
Number of Figures : 0, Number of Tables : 1, Number of References : 8