Morphological changes in the ureteral wall in contact ureterolithotripsy

We studied a harmful action of laser, ultrasound and ballistic energies on intact wall of human ureter in 15 ureters of men and women with renal carcinoma aged 43-55 years (mean age 48+-8 years) before nephrureterectomy in vivo. With growing time of exposure to laser radiation, ureteral mucosa undergoes destructive alterations up to muscular layer. Ureteral wall exposure to ultrasound do not change thickness of the wall considerably, cell elements remain viable. Histological examination of the ureteral wall after exposure to intraureteral ballistic impact suggests that 15 second and longer exposure to this impact may reduce probability of mucosal regeneration because of irreversible changes. The analysis of literature data and original findings shows that now there is no absolutely safe energy for contact ureterolithotripsy.

contact ureterolithotripsy, laser, ultrasound and ballistic energy, damage to the ureter