comparison of the success rate of percutaneous nephrolithotomy with laparoscopic ureterolithotomy in proximal ureteral stones larger than 1cm

The purpose of this study was to compare the success rate of percutaneous nephrolithotomy with laparoscopic ureterolithotomy in proximal ureteral stones larger than 1cm. From September 2004 through September 2006، 40 patients were selected and assigned in a randomized sequential order to a treatment، with 20 patients in each group of PNL and LUL. Routine lab tests and IVP were performed for all patients. After operation، routine lab tests and KUB were performed for all patients in the hospital and KUB and ultrasonography 2 weeks later. The mean age of the patients in PNL group was 39. 4 (16-63) years and in LUL group was 35. 2 (18-57) years. The mean stone size in PNL group was 14. 2 (10-25) mm and in LUL group was 13. 5 (10-28) mm. Success rate was 100% in both groups. Complications were blood transfusion in two patients in PNL group، fever in 3 patients in PNL group and in 2 patients in LUL group، needed an ICU stay for 1 day in 1 patient in LUL group and prolonged urine leakage in 2 patients in LUL group. Blind access and totally tubeless PNL is a rapid، safe and effective option for large upper ureteral calculi in case of moderate to severe hydronephrosis. Laparoscopy has good results such as PNL but it needs incision of ureter which is similar to open surgery that causes urine leakage and prolongs hospital admission، it needs longer operation time، and special equipment، and is more expensive. It seems that، percutaneous nephrolithotomy is a better option than laparoscopic ureterolithotomy for the treatment of proximal ureteral stone larger than 1 cm.