Is routine dilation of the ureter necessary for ureteroscopy?

The results of transurethral ureteroscopic stone removal in 144 patients were reviewed. Patients were treated by two different techniques according to the dilation of the ureterovesical junction before the introduction of the ureteroscope. Group 1 was represented by 71 patients submitted to ureteral dilation and in group 2 there were 73 patients treated without ureteral dilation. There was only one failure in introducing the instrument without ureteral dilation. In patients submitted to transurethral ureteroscopy with previous ureteral dilation, the success of ureteroscopic stone removal was 91.6% and complications occurred in 6.9%, and, in the cases not submitted to ureteral dilation, the success rate was 99.4% and the complication rate 4.1%. The success rate achieved in removing upper third stones was 100.0% middle third 90.5% and lower third stones 95.6%. Of the 144 patients treated, 8 (5.5%) had ureteral injury, but only 1 (0.6%) needed open surgery. We do not believe that ureteral dilation prevents complications or improves the results of ureteroscopic lithotripsy.