[Ureterocele and urolithiasis].

We studied 51 patients with true ureterocele (primarily, orthotopic and unilateral--84.3 and 82.3%, respectively) combined with urolithiasis. Mean age of the patients was 41.9 +/- 2.0 years, size of ureterocele--20.7 +/- 1.3 mm and mean concrement area--1.4 +/- 0.2 cm2. In adult patients with orthotopic or heterotopic disease surgery consisted of perforation (n = 5) or dissection of ureterocele wall (n = 38). Endoscopic operations were indicated in small and middle sized ureterocele (less than 30 mm in size), unaffected contractility of terminal ureter, moderate urodynamic disorders of the upper urinary tracts, normal function of the kidney and no pyelonephritis exacerbation. Endoscopic section of ureterocele wall combined with ureterolithoextraction (n = 26), contact ureterolithotripsy using Ho:YAG laser or ultrasound (n = 19). Open surgery (ureterocystoneostomy by Politano-Leadbetter was made in orthotopic ureterocele over 30 mm in size and in marked urodynamic disturbances of the upper urinary tracts (n = 6). At discharge, a complete elimination of the stones in ureterocele patients was 81.6%. Effective use of extracorporeal shock-wave lithotripsy of nephroliths within 2 months after removal of ureterocele raised this percent to 87.7. Thus, choice of surgical policy in ureterocele complicated by urolithiasis depends on its size, variant of combination of this defect with the concrement, anatomofunctional state of the upper and lower urinary tracts, age of the patient and presence of pyelonephritis.