Ureteroscopy in a Resource Limited Setting: The Tikur Anbessa General Specialized Hospital Experience in Addis Ababa, Ethiopia|
Andualem, D.; Be-ede, L.; Mulat, T. & Samodi, L.
Background: Ureteroscopy (URS) is defined as retrograde instrumentation performed with an endoscope
passed through the lower urinary tract directly into the ureter and calyceal system. However, ureteroscopy
has 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
Methods: This was a cross sectional study of patients who underwent URS at TAGSH from 11th September
2010 to 10th September 2011. Medical records of patients were reviewed and data retrieved by a preset
questionnaire. The clinical notes and imaging studies were examined. After the data was collected, it was
analyzed using the statistical software SPSS version 16.
Results: The main indications for ureteroscopy in our study were ureteric stones (64.3%), ureteric stricture
(7.1%), ureteric obstruction of unknown cause (11.9%) and others such as pelviureteric junction (PUJ)
obstruction and non-excreting kidney (16.7%). At ureteroscopy, 38 (45.3%) patients had stone disease
confirmed during ureteroscopy, 20 (23.9%) were diagnosed normal and 16 (19.1%) had ureteric stricture.
Most patients 56 (66.7%) had no post-operative complications. The overall complication rate of the
procedure was 33.3% (n=28). Fourteen (16.7%) patients had abdominal colic, 7 (8.3%) reported
haematuria, 3 (3.6%) had post-operative fever while 4 (4.8%) patients had both colic and haematuria. Only
a single (1.2%) patient had ureteric perforation.
Conclusion: Ureteroscopy is an indispensible diagnostic and interventional procedure. Our study shows we
have a long ways to go to improve our therapeutic ureteroscopic ureteric stone lithotripsy. We can also
conclude that ureteroscopy is a very safe procedure.