Analysis of cause of difficult access during rigid transurethral ureteroscopy and management

[Objective] To analyse the cause of diffcult access during rigid transurethral ureteroscopy and how to manage that case. [Methods] From Oct 2002 to Jun 2005, 326 cases of rigid transurethral ureteroscopy were evaluated retrospectively. [Results] 24 of 326 cases were difficult to perform ureteroscopy, but 10 of 24 cases could be successfully to achieved with skill. 12 of 14 cases with ureter stricture or flexura were rendered to dilate satisfactlly, but for the other two, one tranfer to operation, and one ESWL with ureter catheter. [Conclusions] Difficult access to ureter is not rare. We should be familiar with the anatomy of ureter and master the techniques of operation.