Management of 10–15-mm Proximal Ureteral Stones: Ureteroscopy or Extracorporeal Shockwave Lithotripsy?

Ziaee, Seyed Amir Mohsen; Halimi-Asl, Parham; Aminsharifi, Alireza; Shafi, Hamid; Beigi, Faramarz Mohammad Ali; Basiri, Abbas

doi:10.1016/j.urology.2007.08.025

Cited by 35 publications

(25 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For large stones located exclusively in the upper ureter, the superiority of URS over ESWL is emphasized. For a mean stone size of 10-15 mm, the SFR ranged from 72.5 to 92% for SR-URS and from 58 to 78.6% for ESWL [12][13][14]. For stones ≥15 mm, Aboutaleb reported a 86 and 59% SFR after endoscopic lithotripsy and ESWL, respectively [4].…”

Section: Resultsmentioning

confidence: 99%

How Effective Is Retrograde Semirigid and Flexible Ureteroscopic Lithotripsy for the Treatment of Large Ureteral Stones Equal of or Greater than 15 mm? Results from a Single Center

Kozyrakis¹,

Kratiras²,

Perikleous³

et al. 2019

Urol Int

View full text Add to dashboard Cite

Purpose: To present the results and complications of retrograde ureteroscopic lithotripsy for treatment of large ureteral stones. Methods: Nineteen patients were treated for ureteral stones ≥15 mm detected in CT or plain KUB film. Endoscopy was performed with either a semirigid or flexible ureteroscope. Stone fragmentation was performed using a 30 W Holmium laser. Results: The mean stone size was 20.7 mm (range 15–30). The mean duration of the operation was 82 min (45–140). Measures to prevent retropulsion of fragments into the kidney were not routinely applied. A subsequent RIRS during the same session was necessary in 2 cases. After a single procedure a stone free state was achieved in 15 cases (78.9%), while 4 others required a second session (ESWL or second ureterolithotripsy, 2 cases each). In only 1 patient, the stone-free state was not achieved after a 1.2 procedure per patient (overall success rate 94.7%). The mean duration of hospitalization was 1.9 days (range 1–5). Three patients experienced postoperative pyelonephritis and 2 others prolonged hematuria. Conclusion: Endoscopic lithotripsy is safe and effective in treating large ureteral stones. After a single endoscopic procedure, approximately 4 out of 5 patients are expected to become stone free. This rate increases to 95% with a second session of lithotripsy.

show abstract

Section: Resultsmentioning

confidence: 99%

How Effective Is Retrograde Semirigid and Flexible Ureteroscopic Lithotripsy for the Treatment of Large Ureteral Stones Equal of or Greater than 15 mm? Results from a Single Center

Kozyrakis¹,

Kratiras²,

Perikleous³

et al. 2019

Urol Int

View full text Add to dashboard Cite

show abstract

“…Park et al [2] have treated 218 patients with upper ureteral stones, achieving a 72.4% stone-free rate after a single ESWL session, but the rate decreases to 42% when the stone is >1 cm. High success rates of >90% with ESWL have been previously reported, however it might be less effective (40-79%) for large stones [1,2,3,11,12]. Besides, ESWL does not assure complete relief of obstruction and is often associated with prolonged attacks of pain during stone passage, flank soreness and repeated treatment in a substantial fraction of patients [13].…”

Section: Discussionmentioning

confidence: 99%

“…ESWL was considered to be the primary therapy of uncomplicated upper urinary calculi for noninvasiveness, low morbidity and acceptable efficacy, but the stone-free rate was only 42.1-78.6% when the stone was >1 cm [1,2,3]. The appearance of ureteroscopy has greatly improved the stone clearance rate, however the success rate of proximal ureteral stones has significantly declined compared with middle and lower ones [4,5].…”

Section: Introductionmentioning

confidence: 99%

Experience of Mini-Percutaneous Nephrolithotomy in the Treatment of Large Impacted Proximal Ureteral Stones

Long

Guo

et al. 2013

Urol Int

View full text Add to dashboard Cite

Objectives: To evaluate the efficacy and safety of mini- percutaneous nephrolithotomy (PCNL) in the treatment of large impacted proximal ureteral stones. Methods: We retrospectively reviewed the outcomes of 163 patients who underwent mini-PCNL between January 2006 and August 2010. Mean age was 48.6 years and mean stone size was 18.4 mm. Hydronephrosis and/or hydroureterosis appeared in all patients. In the prone position, percutaneous access (16-Fr sheath) was established by placement of an access needle into the intended calyx under fluoroscopic guidance or combined with ultrasound guidance for complete obstruction by stones while the contrast agent cannot transit. Pneumatic or ultrasonic probes were used throughout ureterorenoscopy for lithotripsy. The ureteral stents and nephrostomy tube were placed at the end of the procedure. Mean drop in hemoglobin, operative time, success rate, hospital stay, and complications were assessed. Results: Mini-PCNL operations were performed successfully in all patients. Mean operation time was 37 min. Mean postoperative hospital stay was 3.6 days. All cases were followed up for 6-20 months. No major complications like hemorrhage, perforation or organic injury were noted during the operation or postoperatively. The stone-free rate in all patients was 95.7%. Calculus had no recurrence during the follow-up period. Hydronephrosis and hydroureterosis disappeared or were relieved. Conclusions: Mini-PCNL is a safe and effective therapy for large impacted proximal ureteral stones.

show abstract

“…Because of its noninvasive and practical nature, SWL has been the preferred therapeutic option [6][7][8], but its success depends on the location of the treated stone(s), with greater success in the management of proximal ureteral calculi. The success rates tend to decrease for distal stones, while stones treated in an emergency setting have a high success rate, similar to those treated with delayed lithotripsy [6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

“…The success rates tend to decrease for distal stones, while stones treated in an emergency setting have a high success rate, similar to those treated with delayed lithotripsy [6][7][8][9][10][11][12]. However, the clinical introduction of URS has significantly changed the treatment concepts for ureteral stones.…”

Section: Introductionmentioning

confidence: 99%

What are the Benefits and Harms of Ureteroscopy Compared with Shock-wave Lithotripsy in the Treatment of Upper Ureteral Stones? A Systematic Review

et al. 2017

View full text Add to dashboard Cite

Management of 10–15-mm Proximal Ureteral Stones: Ureteroscopy or Extracorporeal Shockwave Lithotripsy?

Cited by 35 publications

References 12 publications

How Effective Is Retrograde Semirigid and Flexible Ureteroscopic Lithotripsy for the Treatment of Large Ureteral Stones Equal of or Greater than 15 mm? Results from a Single Center

How Effective Is Retrograde Semirigid and Flexible Ureteroscopic Lithotripsy for the Treatment of Large Ureteral Stones Equal of or Greater than 15 mm? Results from a Single Center

Experience of Mini-Percutaneous Nephrolithotomy in the Treatment of Large Impacted Proximal Ureteral Stones

What are the Benefits and Harms of Ureteroscopy Compared with Shock-wave Lithotripsy in the Treatment of Upper Ureteral Stones? A Systematic Review

Contact Info

Product

Resources

About