Abstract:To examine the causes of difficulties associated with rigid ureteroscopy and make the countermeasures.?Methods?We retrospectively analyzed the clinical data of 47 patients who were observed to have experienced difficulties during a rigid ureteroscopy from March 2015 to May 2018.?Results?We observed that 13 patients showed a difficulty in accurately locating the ureteral orifice. In these patients, catheter insertion trials, use of a resectoscope combined with ureteroscopy, and the creation of a fistula along the kidneys with methylene blue infusion were a few methods that were employed to eventually achieve successful ureteroscope insertion. In the 29 patients who experienced access difficulties and ureteral expansion, holmium laser incision, rotational techniques, control of perfusion volume, and changing the patient’s posture, among other such methods enabled a successful ureteroscopic procedure. Among these patients, successful ureteroscope access was achieved in 19 patients-indwelling double-J stents were inserted in 2, a percutaneous nephroscope was used in 5, and open surgery was performed in 3 patients. 5 patients experienced difficulties with ureteroscope withdrawal. However, the ureteroscope could be successfully removed in all patients after increasing the dose of analgesics and muscle relaxants administered, lubricating the body of the ureteroscope, and/or repeated and patient rotation of body of the ureteroscope.?Conclusion?The causes of difficulties encountered during rigid ureteroscopy are complex and diverse. Based on the difficulties caused by different factors during surgery, the corresponding countermeasures need to be used in a patient. Additionally, flexible usage of various techniques can increase the success rate of surgeries.
