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Emergency Ureteroscopic Management of Acute
Calcular Anuria
Sultan Sultan , Tarek Abdel Bakey
Urology Department, Faculty of Medicine, Minoufiya University
Tanta Med. Sc. J 2007; 2(3):37-42
Article type: original article
Aim: To study the outcome and complications of
emergency ureteroscopy in management of acute calcular anuria.
Patients and methods: 35 patients with calcular anuria were included
in the study. The mean age was 45±18 years with 30 male and 5
females. The diagnosis was based upon anuria associated with high
serum creatinine and hydronephrosis detected by ultrasonography. KUB
was done to detect radio-opaque stones and its location and size.
Emergency ureteroscopy was done to all cases. Results: Bilateral
ureteric calculi were detected in 31 patients and unilateral
ureteric calculus in 4 patients in whom the other kidney was
surgically removed. The stones were localized in the distal ureter
in 50 units and in the proximal ureter in 16 units. 60 stones were
radio-opaque and 6 stones were radiolucent. The mean stone size was
9±3mm. The mean serum creatinine was 7.3±2.5 mg/100 ml. The stone
free rate in the proximal ureteric stones was 50% and for the distal
ureteric stones was 90%. The overall stone free rate was 80%. No
complications were discovered after ureteroscopy to any case. The
urine output increased dramatically immediately after treatment in
all cases. The serum creatinine dropped to the normal level in all
cases (1.2±0.4 mg/100 ml) in 6.9±1.8 days after treatment. The mean
hospital stay was 2.8±1.3 days. Conclusions: Emergency ureteroscopy
is a safe and an appropriate therapeutic option in the management of
acute calcular anuria. It can save patients from a second procedure.
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