A 1 YEAR RETROSPECTIVE REVIEW ON OUTCOME OF URETEROSCOPY (URS) AT ST. PAUL'S HOSPITAL MILLENNIUM MEDICAL COLLEGE, ADDIS ABABA, ETHIOPIA

Abstract

SUMMARY Background: Ureteroscopy is a safe and minimally invasive method of treating stone disease in the kidneys and ureter and gradually become a major diagnostic and therapeutic technique for lesions of both the ureter and intrarenal collecting system. Complications of URS range from minor complications such as colic, fever and haematuria to major complications like ureteric perforation and avulsion. Objective The objective of this study is to review a 1 year experience and assess the outcome of Ureteroscopy (URS) for the management of ureteral stones at St. Paul’s Hospital Millennium Medical College (SPHMMC) Addis Ababa, Ethiopia from February 1, 2017 up to January 31, 2018 G.C Methods: A retrospective cross-sectional review is conducted for patients who have undergone URS procedure from February 1, 2017 up to January 31,2018. All patients who underwent URS procedures in the given time were included with no sampling. Medical records are reviewed and data retrieved by a preset questionnaire. After the data is collected, it is analyzed with computer programs (SPSS version 20) and the result is presented by numbers, ratios, tables and graphs. Depending on the result appropriate interpretations, discussions, conclusions and recommendations are made. The total cost of the project is 33049.5 birr. Result: A total of 106 patients were included in the study. Majority 88 (83%) patients were between age of 21-50 years, the mean age was 36.4 and 64.2% patients were males. Most 96 (90.6%) patients had stone disease during ureteroscopy while 9 (8.5%) were diagnosed as ureteric stricture and 1 (0.9%) normal. Left and right ureteric stones were present in 44 (45.8%) and 45 (46.9%) respectively and 7 (7.3%) had bilateral ureteric stones. Ureteric stones were present in the lower ureter in 38 (41.3%) patients, in mid ureter 13 (14.1%) patients, in upper ureter 41 (44.6%) patients. Size of the stone was < 1 cm in 32 (43.8%) patients, 1 cm to 2 cm in 38 (52.1%) patients and 2 cm to 3 cm in 3 (4.1%) patient. Stones were completely removed in 51 (56%) of patients. The procedure was successful in 93(87.7%) and unsuccessful in 13(12.3%). Among all patients Ureteric stents were passed in 91 (85.8%) patients. Ureteric stents were passed after Ureteroscopy in 82(77.4%) for ureteric stone disease. There was ureteric avulsion in 1 patient (0.9%), ureteral perforation in 3 patients(2.8%) and gross hemorrhage in 2 patients(1.9%). Key terms: ureteroscopy, indication, outcome, SPHMMC