Extracorporeal shock-wave lithotripsy (ESWL) monotherapy for stones in lower ureter

Landau, Ezekiel H.; Pode, Dov; Lencovsky, Zvi; Katz, Guy; Meretyk, Shimon; Shapiro, Amos

doi:10.1016/0090-4295(92)90511-t

Cited by 11 publications

(3 citation statements)

References 18 publications

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“…Several studies have demonstrated the clinical efficacy of ESWL in fragmenting and clearing ureteric calculi [5][6][7][8][9]. Supporters of ESWL claim that it is effective and non-invasive and can be done on an outpatient basis with intravenous sedation [10]. Advances in ureteroscope technology with the introduction of small caliber semirigid and flexible URS combined with the introduction of Holmium YAG laser have improved stone-free rates following URS while decreasing the risk of complications [11][12][13][14].…”

Section: Eswl or Urs For Upper Ureteric Calculi?mentioning

confidence: 99%

Clinical Profile and Comparison of Outcome of Treatment by Extracorporeal Shock Wave Lithotripsy and Ureterorenoscopy in the Management of Upper Ureteric Calculi

Basra

Rn²,

Verma³

et al. 2021

Asian J Pharm Clin Res

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Objective: Urinary calculi are the third most common affliction of the urinary tract, exceeded only by urinary tract infections and pathologic conditions of the prostate. This study was carried out to assess the safety, efficacy, and compare structural and functional outcome after treating the patients of the upper ureteric calculus with Extracorporeal Shock Wave Lithotripsy (ESWL) and Ureterorenoscopy (URS). Methods: A prospective study was conducted on patients with the upper ureteric stone of size 0.5–1.5 cm. A total of 50 patients were included in the study by means of systematic random sampling so as to get 25 patients in each category of ESWL and URS for the treatment of their upper ureteric calculi. Results: The age ranged from 15 years to 55 years. There were 36 males and 14 females in the study of 50 patients, 43 (86%) presented with pain, followed by 4 (8%) presented with hematuria. Twenty-eight (56%) of the patients had stone in the range of 0.5–1.0 cm, and 22 (44%) of the patients had stone in the range of 1.0–1.5 cm. Sixteen (32%) patients had stone within 2 cm of the pelvi-ureteric junction, and 13 (26%) had stone within 2 cm of the sacroiliac joint. Twenty-one (42%) patients had stone in between these two. Of the 50, 25 patients (50%) underwent shock wave lithotripsy, 25 patients (50%) underwent URS. In the ESWL group, 21 (84%) patients were stone-free after single sitting of ESWL. Four patients (16%) who required Re ESWL, after repeat ESWL two became stone-free however 2 (8%) patient of 1.0–1.5 cm category required secondary procedure, that is, URS and became stone free. To achieve stone-free 1.24 procedure was required per patients. Of the 25 patients in the ESWL group, 2 (8%) patient (one steinstrass case and one poor fragmentation case) required secondary procedure. They underwent URS. Both the patient belonged to 1.0–1.5 cm group. URS was done using semirigid ureteroscope using pneumatic Lithoclast. In our study, two patients of each 0.5–1.0 cm and 1.0–1.5 cm category did not become stone free. These four patients were subjected to ESWL and became stone free. Conclusion: The management of the ureteral stone should be decided on individual basis, based on stone size, location, symptoms, obstruction, and the availability of the instruments. For stones of 0.5–1.0 cm, ESWL is the treatment of choice for the upper ureteric stones, with very low Re- ESWL (1.12 sittings) without any requirement of ancilliary procedure. URS may be used for the upper ureteric stones but requirement of ancilliary procedure is high 11.11%. For stones between 1.1 cm and 1.5 cm, ESWL is the preferred modality of treatment for the upper ureteric stones.

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Section: Eswl or Urs For Upper Ureteric Calculi?mentioning

confidence: 99%

Clinical Profile and Comparison of Outcome of Treatment by Extracorporeal Shock Wave Lithotripsy and Ureterorenoscopy in the Management of Upper Ureteric Calculi

Basra

Rn²,

Verma³

et al. 2021

Asian J Pharm Clin Res

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show abstract

“…Several studies have demonstrated the clinical efficacy of ESWL in fragmenting and clearing ureteric stones 7–10 . Supporters of ESWL claim that it is effective and non‐invasive, and can be done on an outpatient basis with intravenous sedation 11 .…”

Section: Introductionmentioning

confidence: 99%

When is open ureterolithotomy indicated for the treatment of ureteral stones?

et al. 2006

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Aim: Improvements in extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy have almost eradicated the need for open surgery in ureteral stones. The aim of this study was to assess characteristics of patients who underwent open ureterolithotomy. Methods: During a 5-year period, a total of 654 patients with ureteral stones were treated. Initial management consisted of ureteroscopy in 524 patients, ESWL in 62 patients and percutaneous nephrolithotomy (PCNL) in 12 patients. Open surgery was performed in 56 patients. Stone location, size and success rates were retrospectively analyzed. Results: Ureteroscopy resulted in successful stone removal in 94%, 98% and 98.5% of proximal, mid and distal ureteral stones, respectively. A total of 14 patients with ureteroscopy failure were referred for open surgery. ESWL treatment resulted in success in 55 patients (88%), and those with ESWL failure were referred for either ureteroscopy (n = 3) or open surgery (n = 4). Open surgery was performed in a total of 56 patients, 38 of whom had been referred from other centers. Stone location was proximal ureter in 25 (44.6%) patients (stone size: 2-12 cm 2 ), mid ureter in five (8.9%) patients (stone size: 2-6 cm 2 ) and distal ureter in 26 (46.4%) patients (stone size: 4-9 cm 2 ). A history of previous unsuccessful endourological procedure was observed in 33 (58%) of 56 patients. Children under age 16 (range 1-15 years) comprised 17.8% of patients undergoing open surgery. Conclusion: Open surgery, which is nowadays being replaced with laparoscopic techniques, is generally indicated for failed endourological procedures (58%), particularly in centers that do not have flexible ureteroscopy or laser lithotriptor, and in patients with larger stones (>3 cm). Children (17.8%) are also candidates for open surgery, if specifically designed endourological equipment is not available.

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“…Miller та співавтори [9] першими повідомили про час тоту «stone free» у 86% випадків після проведення даної ме тодики. Подальші дослідження також підтвердили частоту успішного подрібнення каменів дистального відділу сечово ду у 90% пацієнтів і більше [10][11][12][13][14]. ЕУХЛ є менш інвазив ною методикою порівняно з ендоскопічною технологією та може бути виконаною в амбулаторному режимі (за виклю ченням пацієнтів, яким показана загальна анестезія) з мен шою кількістю ускладнень [27].…”

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Salvage extracorporeal shock wave lithotripsy after ineffective distal contact laser lithotripsy

Головко¹,

Савицький²

2017

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Extracorporeal shock-wave lithotripsy (ESWL) monotherapy for stones in lower ureter

Cited by 11 publications

References 18 publications

Clinical Profile and Comparison of Outcome of Treatment by Extracorporeal Shock Wave Lithotripsy and Ureterorenoscopy in the Management of Upper Ureteric Calculi

Clinical Profile and Comparison of Outcome of Treatment by Extracorporeal Shock Wave Lithotripsy and Ureterorenoscopy in the Management of Upper Ureteric Calculi

When is open ureterolithotomy indicated for the treatment of ureteral stones?

Salvage extracorporeal shock wave lithotripsy after ineffective distal contact laser lithotripsy

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