Ureteroscopy with intravenous sedation for treatment of distal ureteral calculi: A safe and effective alternative to shock wave lithotripsy

Purpose: We evaluated the safety, efficacy and patient tolerance of ureterosco Materials and Methods: Ureteroscopy with intravenous sedation was performed in 68 patients with small distal ureteral calculi requiring treatment and in 2 with middle or upper third ureteral calculi. Intravenous sedation and analgesia were achieved with a combination of fentanyl and midazolam. Balloon dilation of the ureter was performed in 38 patients. Ureteroscopy was performed with a 6F rigid ureteroscope. Results: Stone removal was successful in 66 patients (97%). There were no ureteral perforations in patients undergoing successful stone removal and no complications related to intravenous sedation. Tolerance of the procedure was good in 81% of the patients (including 72% of 36 men and 94% of 32 women undergoing ureteroscopy for distal ureteral calculi) and fair in 19%. Conclusions: In select patients with small distal ureteral calculi ureteroscopy offers a safe, effective and well tolerated alternative to shock wave lithotripsy.