Anatomial Variations in Ureteric Course and Their Clinical Significance in Urolithiasis and Endourological Procedures

Authors

  • Amna Mubeen Professor, Anatomy Department. Sargodha Medical College.
  • Tahrim Ansar Professor, Anatomy Department. Abu Umara Medical and Dental College, Lahore.
  • Zafar Iqbal Associate Professor, Anatomy Department. Niazi Medical and Dental College Sargodha.
  • Nimrah Fahim Senior Demonstrator, Anatomy Department. Shifa College of Medicine. Islamabad.
  • Rifat Shamim Associate Professor. Anatomy Department. Niazi Medical and Dental College Sargodha
  • Farhat Humayun Lecturer of Anatomy, Basic Medical Sciences Department. Sulaiman Al Rajhi University. College of Medicine. Al Bukayriyah. Saudi Arabia.

Keywords:

Ureteric Variations, Urolithiasis, Ureteroscopy, Endourology, CT Urography, Stone Clearance.

Abstract

Objective: To evaluate the frequency and types of anatomical variations in the ureteric course and to assess their clinical significance in patients with urolithiasis undergoing endourological procedures.

Materials and Methods: This cross-sectional observational study was conducted over a period of one year. A total of 120 patients diagnosed with urolithiasis and planned for endourological procedures, including ureteroscopy (URS), retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) were included. Preoperative assessment involved clinical evaluation and radiological imaging, primarily non-contrast CT and CT urography where indicated. Ureteric anatomical variations were identified through imaging and confirmed intraoperatively. Data regarding demographic characteristics, stone location, type of ureteric variation, procedural difficulty, complications and stone clearance were recorded and analyzed using SPSS version 22.

Results: Out of 120 patients, ureteric anatomical variations were observed in 34 patients (28.3%). The most common variation was ureteric tortuosity (35.3%) followed by duplication (23.5%), kinking (20.6%) and medial/lateral deviation (20.6%). Procedural difficulty was significantly higher in patients with ureteric variations (64.7%) compared to those with normal anatomy (20.9%) (p < 0.05). Complication rates, including mucosal injury and ureteric perforation were also increased in patients with variations. Furthermore, the stone clearance rate was lower in patients with ureteric variations (79.4%) compared to those with normal ureters (94.1%).

Conclusion: Anatomical variations of the ureteric course are common and have a significant impact on the management and outcomes of urolithiasis. Awareness and identification of these variations through appropriate imaging and careful intraoperative assessment are essential to minimize complications and improve the success of endourological procedures.

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Published

2026-04-20

How to Cite

Amna Mubeen, Tahrim Ansar, Zafar Iqbal, Nimrah Fahim, Rifat Shamim, & Farhat Humayun. (2026). Anatomial Variations in Ureteric Course and Their Clinical Significance in Urolithiasis and Endourological Procedures. International Journal of Pharmacy Research & Technology (IJPRT), 16(1), 1759–1766. Retrieved from https://ijprt.org/index.php/pub/article/view/1772

Issue

Vol. 16 No. 1 (2026)

Section

Research Article

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.