Reply by the Author

Mohamed El Ghoneimy

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TO THE EDITOR:Having read the letter to the editor, I have found it to describe the problems faced during semirigid ufeteroscopyfor upper ureteral stones with a high degree of clinical expertise. I do agree with the authors regarding the relative unsuitability of the male urinary tract for upper tract ureteroscopy. However, we have found that sometimes dilation of the intramural ureter can help, not only in the extraction of larger stone fragments, but also in patients with a rigid lower ureter. This is usually possible in the vast majority of young males, albeit a few patients will have nondilatable lower ureters. In patients with prominent adenoma, we usually proceed to direct ureteroscopy without the use of any cystoscopy sheath to facilitate the ascent of the scope to the upper ureter.

机译：致编辑：在阅读致编辑的信之后，我发现它可以描述具有较高临床专业知识的半刚性输尿管镜检查对输尿管上段结石所面临的问题。对于男性尿路相对于上输尿管镜检查的相对不合适性，我确实同意作者的观点。但是，我们发现有时扩张壁内输尿管不仅可以帮助取出较大的结石碎片，而且对于具有刚性下输尿管的患者也有帮助。这在绝大多数年轻男性中通常是可能的，尽管有少数患者的下输尿管不可扩张。对于有明显腺瘤的患者，我们通常直接进行输尿管镜检查，而无需使用任何膀胱镜检查套以利于将范围扩大到上输尿管。

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《Urology》 |2012年第4期|共2页
作者
Mohamed El Ghoneimy;
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中图分类泌尿科学（泌尿生殖系疾病）;
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