Ureterolithotomy Workup

  • Author: Jeffrey M Donohoe, MD, FAAP; Chief Editor: Bradley Fields Schwartz, DO, FACS   more...
 
Updated: Nov 30, 2011
 

Laboratory Studies

  • Obtain a CBC count, chemistry panel, BUN, creatinine, and prothrombin time/international normalized ratio (INR), as well as urinalysis and urine culture.
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Imaging Studies

  • Plain radiography performed preoperatively is strongly advised because stones often change position and may even pass. While most stones in the kidneys, ureters, and bladder (KUB) are radiopaque on plain radiography, they can be visualized in the course of the ureter.
  • Intravenous pyelography (IVP) is an effective means of assessing function and stone position, as well as distinguishing stones from phleboliths. At times, oblique films and delayed pictures may have to be obtained.
  • Ultrasonography is a useful modality.
  • CT scans can reveal smaller stones and other causes of abdominal pain. Scans are performed with no dye. CT scans also reveal nonopaque stones, but renal function cannot be assessed adequately. Also, CT scan is very expensive, so its use is limited to some complicated cases.
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Other Tests

  • Obtaining ECG, chest radiography, and preoperative radiography of KUB to visualize the position of the stone in the ureter is advisable.
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Contributor Information and Disclosures
Author

Jeffrey M Donohoe, MD, FAAP  Assistant Professor of Pediatric Urology, Department of Surgery, Division of Urology, Children's Medical Center, Medical College of Georgia

Jeffrey M Donohoe, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics and American Urological Association

Disclosure: Nothing to disclose.

Coauthor(s)

Sisir Botta, MD  Resident Physician, Department of Urology, Medical College of Georgia

Disclosure: Nothing to disclose.

James A Brown, MD, FACS  Associate Professor, Department of Surgery, Medical College of Georgia; Consulting Staff, Head of Urologic Oncology, Veterans Affairs Medical Center

James A Brown, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Phi Beta Kappa, Society for Basic Urologic Research, Society of Laparoendoscopic Surgeons, and Society of Urologic Oncology

Disclosure: Nothing to disclose.

Subbarao V Cherukuri, MD  Consulting Staff, Department of Urology, St Joseph Regional Health Center

Subbarao V Cherukuri, MD is a member of the following medical societies: American Urological Association and Ohio State Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael Grasso III, MD  Director of Endourology, Lenox Hill Hospital; Professor and Vice Chairman, Department of Urology, New York Medical College

Michael Grasso III, MD is a member of the following medical societies: American Medical Association, American Urological Association, Endourological Society, Medical Society of the State of New York, National Kidney Foundation, Société Internationale d'Urologie (International Society of Urology), and Society of Laparoendoscopic Surgeons

Disclosure: Karl Storz Endoscopy Consulting fee Consulting; Boston Scientific Consulting fee Consulting; Cook Urologic Consulting fee Consulting

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Martin I Resnick, MD †  Former Lester Persky Professor and Chair, Department of Urology, Former Professor, Department of Oncology, Case Western Reserve University School of Medicine

Martin I Resnick, MD † is a member of the following medical societies: American College of Surgeons, American Federation for Medical Research, American Institute of Ultrasound in Medicine, American Medical Association, American Society for Bone and Mineral Research, American Society for Reproductive Medicine, American Society of Andrology, American Surgical Association, American Urological Association, Association for Academic Surgery, Endocrine Society, National Kidney Foundation, Ohio Urological Society, and Pan American Medical Association

Disclosure: Nothing to disclose.

J Stuart Wolf Jr, MD, FACS  The David A Bloom Professor of Urology, Director, Division of Endourology and Stone Disease, Department of Urology, University of Michigan Medical School

J Stuart Wolf Jr, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Catholic Medical Association, Endourological Society, Society for Urology and Engineering, Society of Laparoendoscopic Surgeons, Society of University Urologists, and Society of Urologic Oncology

Disclosure: Nothing to disclose.

Chief Editor

Bradley Fields Schwartz, DO, FACS  Professor of Urology, Director, Center for Laparoscopy and Endourology, Department of Surgery, Southern Illinois University School of Medicine

Bradley Fields Schwartz, DO, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Association of Military Osteopathic Physicians and Surgeons, Endourological Society, Society of Laparoendoscopic Surgeons, and Society of University Urologists

Disclosure: Nothing to disclose.

Additional Contributors

Medscape Reference thanks Dennis G Lusaya, MD, Associate Professor II, Department of Surgery (Urology), University of Santo Tomas; Head of Urology Unit, Benavides Cancer Institute, University of Santo Tomas Hospital; Chief of Urologic Oncology, St Luke’s Medical Center Global City, Philippines, for the video contribution to this article.

Medscape Reference also thanks Edgar V Lerma, MD, FACP, FASN, FAHA, Clinical Associate Professor of Medicine, Section of Nephrology, Department of Medicine, University of Illinois at Chicago College of Medicine; Research Director, Internal Medicine Training Program, Advocate Christ Medical Center; Consulting Staff, Associates in Nephrology, SC, for his assistance with the video contribution to this article.

References

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  2. Rofeim O, Yohannes P, Badlani GH. Does laparoscopic ureterolithotomy replace shock-wave lithotripsy or ureteroscopy for ureteral stones?. Curr Opin Urol. May 2001;11(3):287-91. [Medline].

  3. El-Moula MG, Abdallah A, El-Anany F, Abdelsalam Y, Abolyosr A, Abdelhameed D, et al. Laparoscopic ureterolithotomy: our experience with 74 cases. Int J Urol. Jul 2008;15(7):593-7. [Medline].

  4. Adams, JB. Ureteral Surgery. In: Smith A, Badlani GH, Bagley DH, et al, eds. Smith's Textbook of Endourology. St Louis, Mo: Quality Medical Publishing Inc; 1996:962-76.

  5. Gil-Vernet J. New surgical concepts in removing renal calculi. Urol Int. 1965;20(5):255-88. [Medline].

  6. Mandhani A, Kapoor R. Laparoscopic ureterolithotomy for lower ureteric stones: Steps to make it a simple procedure. Indian J Urol. Jan 2009;25(1):140-2. [Medline].

  7. Marberger M. Ureterolithotomy. In: Graham JD Jr, Glenn JF, eds. Glenn's Urological Surgery. 5th ed. Philadelphia, Pa: Lippincott-Raven; 1999:63-8.

  8. Resnick MI, Spirnak JP. Kidney and ureteral stone surgery. In: Adult and Pediatric Urology. Vol 1. St. Louis, Mo: Mosby Year Book; 1991:637-40.

  9. Stolzenburg JU, Katsakiori PF, Liatsikos EN. Role of laparoscopy for reconstructive urology. Curr Opin Urol. Nov 2006;16(6):413-8. [Medline].

  10. Walsh PC, et al. Campbell's Urology. 1997. 7th ed. Philadelphia, Pa: WB Saunders.

 
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Laparoscopic ureterolithotomy. Video courtesy of Dennis G Lusaya, MD, and Edgar V Lerma, MD.
 
 
 
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