Dr Muhammad Bilal Bhatti, Dr Wajiha Arshad, Dr Humna Riaz
Objective: The aim of this study was to provide the comparison of effectiveness and safety of F-URS (Flexible Ureteroscopy) and TPLU (Trans peritoneal Laparoscopic Ureter lithotomy) in the patients suffering from obstructive pyelonephritis. Methodology: A group of forty patients appeared with obstructive pyelonephritis because of proximal ureteral stones having larger size than 1.50 centimeters, were included in this research work. The duration of this study was from January 2015 to January 2020. After pyonephrosis’ drainage and sepsis’s resolution, twenty patients underwent treatment with TPLU (Group-1) and twenty patients underwent treatment with the utilization of F-URS (Group-2). Before surgical intervention, characteristic of stones, parameters related with procedures and clinical outcomes were evaluated in both groups. Results: The findings of this research work showed that, both procedures are much efficient in treating the proximal ureteral stones of large size. High stone free rate was provided by the TPLU (100.0% vs 80.0%. P=0.0430) and TPLU also provided the low rate of retreatment. We found no difference in the patients of both groups for duration of surgery and rate of complication. Patients who got treatment with the procedure of F-URS were present with less pain after surgery (P=0.0080), a short stay at hospital (P<0.0010) and very fast return to their routine daily activities (P<0.001). Conclusions: Results of this research work concluded that both procedures are much effective and secure for the treatment of the proximal ureteral stones of large size after getting control on obstructive pyelonephritis. There is high stone free rate provided by the TPLU with comparable duration of surgery and rate of complication in comparison with the procedure of F-URS. There are also some advantages of F-URS as less pain after surgical intervention, fast return to normal routine activities and less stay in hospital. Key Words: Obstructive, Pyelonephritis, Flexible Ureteroscopy, Ureter Lithotomy, Stones.