Complications of ureteral endoscopy.

Use of the rigid ureterorenoscope has become widely accepted for the diagnosis of ureteral lesions, and for the removal and disintegration of ureteral calculi. Few complications have been reported. During the last 3 years 128 ureteroscopic procedures were performed for a variety of indications (98 for stone disease). There were 26 complications: 22 minor with no morbidity and 4 major that required surgical correction. Minor complications consisted of asymptomatic ureteral perforations in 6 patients, perforations with urinary extravasation, pain, ileus or fever in 4, migration of the stone into the kidney in 10 and migration of the stone outside the ureter with the calculus left in situ in 2. Major complications included ureteral perforation during basket extraction of an upper ureteral stone, urinoma following perforation and requiring drainage, stenosis of the intramural ureter that was corrected by marsupialization and aseptic necrosis of the ureter that was treated by ileal replacement.