To investigate the safety, efficacy and practicability of retroperitoneal laparoscopic ureterolithotomy in the treatment of inferior ureteral calculi with infection.

Retrospective analysis of 6 patients diagnosed with incarcerated ureteral calculi with infection in our department from June 2017 to June 2019, 4 of them failed after ESWL, 2 had positive urine culture before surgery and accompanied with fever before operation, the routine WBC of urine was positive (++~+++), The laparoscopic ureteral calculi incision and stone removal were performed. The operation time, postoperative intestinal function recovery time, total hospitalization days and related complication were recorded.

All the 6 patients were successfully treated with retroperitoneal laparoscopic lithotomy of the lower segment of the ureter, and none of them were converted to laparoscopic uretholithotomy or open surgery through abdominal approach.The operation time was 55-100 (mean 82.5) min;the postoperative intestinal function recovery time was 1-2 days (average 1.7 days), and the total hospital stay was 7-13 (mean 8.5) days. One case had low back pain and fever after removal of the urethral catheter. Considering the extravasation of benign prostatic hyperplasia, urinary retention, and urinary reflux, the symptoms disappeared after the catheterization was preserved. During the follow-up period from three to twelve months, there were no serious complications such as recurrence of stones and ureteral stricture.

Laparoscopic lower uretholithotomy via retroabdominal approach is safe and feasible, with less trauma and faster recovery. It is especially suitable for patients with ureter calculi with infection. It is worth popularizing in clinic, but it puts forward higher requirements for retroperitoneal anatomy and endoscopic surgery.