Objectives: Ureteroscopy has become an effective and safe procedure for treatment of ureteral calculi. Formation of strictures are considered long-term complications with a low incidence. This report focuses on the incidence of strictures in cases of calculi pushed or flushed retroperitoneally alongside the ureter because of iatrogenic ureteral perforation.
Methods: Fifteen consecutive patients with paraureteral calculi caused by ureteroscopic perforation were observed. An excretory urogram was performed after a mean of 22.5 months, with a range of 9 to 54 months. In all patients, a stent was placed for 3 to 41 days (mean, 13.5 days) and antibiotics were administered between 3 and 5 days postoperatively.
Results: Only 1 patient of 15 with a short stricture of the distal ureter was observed. The stricture was successfully treated by endoscopic ureterotomy, balloon dilation, and transient placement of a ureteral stent.
Conclusions: Paraureteral calculi caused by ureteral perforation are a minor complication of ureteroscopy, which rarely lead to formation of strictures. Removal of paraureteral calculi by enhanced endoscopic procedures or open surgery is not required.