Extracorporeal shock-wave lithotripsy for stones in middle third of ureter (overlying pelvic bone)

Cass, Alexander S.

doi:10.1016/0090-4295(94)90041-8

Cited by 18 publications

(7 citation statements)

References 6 publications

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“…However, it may be attenuated by gas-containing bowel interposed between the shock wave source and the stone [2]. Cass [12] reported 75-80% stone-free rates with ESWL for stones in the midureter. In the presented study, patients with midureteral stone had not previously undergone ESWL treatment.…”

Section: Discussionmentioning

confidence: 98%

Routine ureteral dilatation is not necessary for ureteroscopy

2004

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Section: Discussionmentioning

confidence: 98%

Routine ureteral dilatation is not necessary for ureteroscopy

2004

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“…consensus about the most appropriate treatment, ESWL has gained worldwide acceptance as first line therapy for small stones and the success rates for these stones ranges between 59.6 and 96%. [1][2][3][4][5][6][7][8][12][13][14] However, the efficiency of ESWL may vary according to the stone size, stone composition, impaction of the stone and existence of obstruction. 14,15 Stones larger than 1 cm are often associated with impaction or obstruction.…”

Section: Discussionmentioning

confidence: 99%

What is the optimal treatment for lower ureteral stones larger than 1cm?

et al. 2000

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Purpose: To compare the treatment options for lower ureteral stones larger than 1 cm. Methods:The records of 449 patients with lower ureteral calculi larger than 1 cm were reviewed retrospectively. Of these patients 342 (76.1%) were treated with extracorporeal shock wave lithotripsy (ESWL) (group 1), 66 (14.7%) with pneumatic lithotripsy (PL) (group 2) and 128 (28.5%) with ureterolithotomy (group 3). Eighty-seven (19.5%) patients underwent any of the two treatment modalities because of unsuccessful primary treatment. Results:The overall stone-free rates were 32.4, 90.9 and 95.3% for ESWL, PL and ureterolithotomy, respectively. These values were 84.4% for primary PL and 96.7% for primary ureterolithotomy. The re-treatment rate (46.4%) and secondary procedures were much more frequent in the ESWL group. There was no difference in the complication rates of the three groups. Conclusions: Pneumatic lithotripsy with ureteroscopy seems to be an appropriate treatment for larger ureteral stones. While ESWL can be tried as a first treatment option because of its noninvasive nature, lower success and higher re-treatment rates limit its usefulness. Ureterolithotomy is still a reasonable alternative for these large or unfragmented stones.

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“…The stratification of the results for the stone site, compared to those achieved with shock-wave lithotripsy [1, 14, 15, 16, 17, 18, 19, 20, 21], show that the one-session solution is more common in the iliac and especially lower ureter and that the accidental push up is not uncommon for the upper ureteric stones (table 3). For this purpose, irrigation should be kept to a minimum until the stone is reached and possibly entrapped within a basket.…”

Section: Discussionmentioning

confidence: 99%