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Vaginal Ureterolithotomy
Author(s) -
O'BOYLE P. J.,
GIBBON N. O. K.
Publication year - 1976
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1976.tb03006.x
Subject(s) - medicine , vagina , ureter , calculus (dental) , surgery , general surgery , dentistry
The surgical management of the low ureteric calculus has been revolutionised by the development of endoscopic techniques of extraction (Constantian, 1974). Nevertheless, not infrequently in urological practice is it necessary to remove an impacted calculus which has failed to respond to conventional manoeuvres. The abdominal approaches, whether retroperitoneal, transperitoneal or transvesical, each have their advocates but also their difficulties, particularly in the obese patient or following previous pelvic surgery. It is our contention that the simplest surgical approach in the female is through the lateral vaginal wall. This provides rapid and easy access to the lower ureter. We have used this method on 5 occasions in the last 2 years and in 2 cases have been thwarted by proximal displacement of the stone which was subsequently removed by open operation. The fundamental indication for the vaginal approach is the removal of a low ureteric calculus which can be readily palpated through an adequate vagina and which is not amenable to endoscopic extraction. It may also be used to advantage in the poor risk or toxic patient.