Analysis of the diffculties in accessing into ureter during rigid transurethral ureteroscopy and management

Objective To analysis the causes of the diffculties in accessing into ureter during rigid transurethral ureteroscopy and management.Methods Rigid transurethral ureteroscopy was conducted in 312 patients with ureteral stones.Difficulties of ueteroscope in accessing into ueter was encountered in 46 patients and overcame by adjusting the pressure of hydraulic irrigation,changing the position of patient,or dilating the ureter.Results Of the 46 patients with difficult retrograde access,successful ureteroscopy was achieved in 31 patients,conversions to open ureterolithotomy were required in 9 patients and ESWL were conduncted after inserting ureter catheter in 4 patients with.Conclusion The key to successful retrograde access of rigid ureteroscope lies in the acquaintance with normal and pathologic anatomy and physiology of the ureter and urologist’s operative skills and experience.