- Author: George M Ghareeb, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS more...
Obtain a complete blood count (CBC), basic metabolic panel (BMP) including BUN and creatinine, as well as a urinalysis and urine culture.
The following imaging studies are recommended:
- In most cases, a non-contrast CT Abdomen/Pelvis has already been obtained for flank pain evaluation prior to Urology consultation. CT scans reveal the size and location of the ureteral stone, the presence of any other stones, and the presence or absence of associated hydroureteronephrosis or other causes of flank/abdominal pain.
- Plain radiography (KUB) should be performed following the identification of ureteral stones on CT if medical explusive therapy (MET) is planned. A KUB can show radiopaque stones and are useful for following stones over time. If a radiopaque stone is seen at the time of diagnosis, its presence/movement can be assessed later with repeat KUB. This approach is favored over repeat CT and its associated cost and radiation exposure to the patient. Of course, if the stone is radiolucent (not visible on KUB) then a repeat CT is necessary to follow stone presence/movement over time.
- Ultrasonography is useful for identifying hydroureteronephrosis, but is not reliable for visualizing stones or their location. Intravenous pyelography (IVP) is now rarely performed.
An EKG and chest X-Ray are often part of the preoperative anesthesia evaluation and are especially useful in those patients with known cardiopulmonary disease.
Tracy CR, Raman JD, Cadeddu JA, Rane A. Laparoendoscopic single-site surgery in urology: where have we been and where are we heading?. Nat Clin Pract Urol. 2008 Oct. 5(10):561-8. [Medline].
Rofeim O, Yohannes P, Badlani GH. Does laparoscopic ureterolithotomy replace shock-wave lithotripsy or ureteroscopy for ureteral stones?. Curr Opin Urol. 2001 May. 11(3):287-91. [Medline].
Singh V, Sinha RJ, Gupta DK, Kumar M, Akhtar A. Transperitoneal versus retroperitoneal laparoscopic ureterolithotomy: a prospective randomized comparison study. J Urol. 2013 Mar. 189(3):940-5. [Medline].
Tugcu V, Simsek A, Kargi T, Polat H, Aras B, Tasci AI. Retroperitoneal laparoendoscopic single-site ureterolithotomy versus conventional laparoscopic ureterolithotomy. Urology. 2013 Mar. 81(3):567-72. [Medline].
Fang YQ, Qiu JG, Wang DJ, Zhan HL, Situ J. Comparative study on ureteroscopic lithotripsy and laparoscopic ureterolithotomy for treatment of unilateral upper ureteral stones. Acta Cir Bras. 2012 Mar. 27(3):266-70. [Medline].
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. 2008 Jul. 15(7):593-7. [Medline].
Adams, JB. Ureteral Surgery. Smith A, Badlani GH, Bagley DH, et al, eds. Smith's Textbook of Endourology. St Louis, Mo: Quality Medical Publishing Inc; 1996. 962-76.
Gil-Vernet J. New surgical concepts in removing renal calculi. Urol Int. 1965. 20(5):255-88. [Medline].
Marberger M. Ureterolithotomy. Graham JD Jr, Glenn JF, eds. Glenn's Urological Surgery. 5th ed. Philadelphia, Pa: Lippincott-Raven; 1999. 63-8.
Resnick MI, Spirnak JP. Kidney and ureteral stone surgery. Adult and Pediatric Urology. St. Louis, Mo: Mosby Year Book; 1991. Vol 1: 637-40.
Stolzenburg JU, Katsakiori PF, Liatsikos EN. Role of laparoscopy for reconstructive urology. Curr Opin Urol. 2006 Nov. 16(6):413-8. [Medline].
Walsh PC, et al. Campbell's Urology. 7th ed. Philadelphia, Pa: WB Saunders; 1997: