Management of lower ureteric stones: a prospective study

Abstract

ObjectiveTo discuss the current concepts in lower ureteric stone management.Material and methodsBetween October 2008 and November 2010, 190 patients of both sexes and of different age groups with lower ureteric stones, underwent in situ extracorporeal shock wave lithotripsy (ESWL) (48 cases), ureterorenoscopy (URS) (120 cases) and open stone surgery (OSS) (22 cases).The patients’ clinical and radiological findings, as well as stone characteristics, were reviewed and correlated with the stone–free status.ResultsIn the ESWL group, the operative time was 43.13 +22.5 min; the average number of sessions/patients was 1.5 sessions; the average number of SW/patients was 4500 SW/patients; the average energy was 16.5 kV; the average stone burden was 7.8/mm; the overall stone–free rate was 75% (36/48); and the average radiation exposure time was 3.5 min.In the URS group, the operative time was 49.21 +16.09 min; the average stone burden was 10.81mm; the overall stone–free rate was 97.5% (117/120); the average hospital stay was 3.99 days; and the average radiation exposure time was 0.75 min.In the OSS group, the operative time was 112.38 +37.1 min; the overall stone–free rate was 100% (22/22); and the average hospital stay was 9.74 days.ConclusionIn the management of patients with lower ureteral stones, URS, SWL and OSS were considered acceptable treatment options.This recommendation was based on the stone–free results, morbidity and retreatment rates for each therapy.

Predictive factors of extracorporeal shock wave lithotripsy failure in the treatment of patients with ureterolithiasis

“…Even if intervention passed 98 days post-symptom onset, staged URSL, alternative procedures, and detailed informed consent should be planned in advance. Due to high efficacy of ESWL and URS in patients with urolothiasis, there is a need for a clear understanding of their advantages and disadvantages [15,16].…”

Comparison of the Intracorporeal Ultrasonic Lithotripsy and Intracorporeal Pneumatic Lithotripsy in Terms of Stone Removal and Postoperative Complications

“…Current indications include cases involving the anatomical ureteric abnormalities, impacted stones, and failure of the minimally invasive modalities. 9 Obstructive uropathy due to urinary stones is a medical emergency and requires urgent diagnosis and treatment for the purpose of decompression. Ureterorenoscopic lithotripsy has high success rates with minimal morbidity and can be performed with safety in selected subjects.…”

Evaluation of Outcome of Ureteroscopic Pneumatic Lithotripsy in Single Lower Ureteric Calculus and Its Association with CT Parameters

“…Ureteroscopic lithotripsy (URSL) is a good intervention modality for treatment of ureteric stones [8]. Its outcome is affected by size, position and nature of stones.…”