Upper ureteric stones are a common urologic problem that can cause significant morbidity if left untreated. Simi-rigid ureteroscopy (URS) is a minimally invasive procedure that has been increasingly used for the management of upper ureteric stones. In this procedure, a ureteroscopy is passed through the urethra and bladder into the ureter, and the stone is removed using a laser or a basket. Here we will take the management of upper ureteric stones using Simi-rigid ureteroscopy.
Upper ureteric stone (UUS) surgical
intervention has been a major challenge in developing countries, due to
high cost and non-availability of Extracorporeal Shock Waves Lithotripsy
(EWSL) and Flexible Ureteroscopy (URS), as they are the standard
intervention for UUS. Our objectives are to evaluate the outcome and
complications of the use of Semi-rigid URS in interventions of upper ureteric stones.

This is a cross sectional Hospital based study was conduct in
Sudan, Khartoum at Ibnsina Specialized hospital, during the period from February
2022 to October 2022, with total number of 223 patients underwent Semirigid
Ureteroscopy was performed in the lithotomy position under spinal anesthesia using a 8.5/8 Fr semirigid ureteroscope (Karl Storz Endoscope, Tuttlingen, Germany). Holmium-YAG laser lithotripter (VersaPulse PowerSuite, Lumenis Surgical, San Jose, CA, USA) was used for stone fragmentation and a 365-μm laser fiber was employed (power setting: 0.8–1.0 J × 10–15 Hz). 
(130 males 58.3 %, 93 females 41.7 %) with a mean age of 44.6 years old
(range 20-76), underwent Primary URS 206 (92.4%) are single stone, 7
(3.1%) are bilateral stones and 10 (4.5%) are Steinstrasse stone. All are
upper ureteric stones with mean size of 1.7 mm (1.2-5.0mm) with mean time of 24.5 min
with range of (10-55 min). Ureteric stent was inserted in all patients.

Of 223 patients, the majority (203 = 91%) were successfully
cleared after a single procedure, except 20 (9%), nine of them underwent
second session for incomplete stone clearance, six patients (2.7%) had
stone migration and in 3 (1.3%) patients the stones were difficult to
access. Minor complications of mucosal injury 29 (13%), false passage 13
(5.8) not interrupted surgery or stone fragmentation. No major
complications of avulsion, perforation or bleeding.

our stone free rate is 91% which is near to the same percentage of study was conducted at 2010 (1)

The result of the study shows that semi-rigid URS is a
safe and successful alternative procedure to ESWL and Flexible URS in
interventions for upper ureteric stones with minimal risk of mucosal injury, false passage or
migration.

Yencilek F, Sarica K, Erturhan S, Yagci F, Erbagci A: Treatment of Ureteral Calculi with Semirigid Ureteroscopy: Where Should We Stop? Urol Int 2010;84:260-264. doi: 10.1159/000288225