Management of Upper Ureteral Calculi with Extracorporeal Shock wave Lithotripsy

Lingeman, James E.; Shirrell, William L.; Newman, Daniel M.; Mosbaugh, Phillip G.; Steele, Ronald E.; Woods, John R.

doi:10.1016/s0022-5347(17)43351-9

Cited by 155 publications

(49 citation statements)

References 9 publications

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“…The rate free of stones (96%) was comparable to the results of other groups, ranging from 88 to 97% (table 4) [Graff et al, 1988;Lingeman et al, 1987;Müller et al, 1986;Meacham and Carlton, 1986]. It is superior to the outcome of ureteroscopy, which achieved successful treatment in 78-80% of the cases [Arnold and Lyon, 1986].…”

Section: Discussionsupporting

confidence: 56%

Management of Ureteral Stones by Extracorporeal Shock Wave Lithotripsy

Recker

Jaeger²,

Alund³

et al. 1989

Urol Int

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From April 1985 to March 1987 181 patients with ureteral stones were treated by means of extracorporeal shock wave lithotripsy (ESWL). Management for proximal calculi changed from in situ ESWL treatment (group n = 27) or placement of a ureteral catheter below calculi (group II, n = 30) to retrograde stone manipulation into renal pelvis (group IV, n = 52) or ESWL treatment under intraoperative irrigation of saline in cases where repositioning failed (group III, n = 50). The best stone-free rate for upper ureteral stones was obtained in group IV with 96% after 6 weeks, presenting also the shortest hospital stay (4.2 days) and lowest quota of postoperative auxiliary procedures (2%). Stones, not being dislodged into renal pelvis (49%), could be treated successfully in 86% by irrigation with saline during ESWL (group III). The stone-free rate decreased in patients with in situ treatment (group I: 67%) or ureteral catheter placement (group II: 83%). Treatment of these stones increased the need of postoperative ancillary procedures to approximately 30%. For distal ureteral stones ESWL and preoperative Zeiss placement achieved a stone-free rate of 95%.

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Section: Discussionsupporting

confidence: 56%

Management of Ureteral Stones by Extracorporeal Shock Wave Lithotripsy

Recker

Jaeger²,

Alund³

et al. 1989

Urol Int

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“…Extracorporeal shockwave lithotripsy (SWL) is widely used for treatment of ureteral stones as well as ureteroscopic techniques with a high rate of success (3,4). However, poor results have been obtained with the treatment of impacted ureteral stones by SWL (5,6). On the other hand, ureteroscopic approach is not so easy and has a high rate of complications (2).…”

Section: Introductionmentioning

confidence: 99%

Ureteroscopic pneumatic lithotripsy of impacted ureteral calculi

2006

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Introduction: This work evaluates the results of ureteroscopic treatment of impacted ureteral stones with a pneumatic lithotripter. Materials and Methods: From March 1997 to May 2002, 42 patients with impacted ureteral stones were treated by retrograde ureteroscopic pneumatic lithotripsy. Twenty-eight patients were female and 14 were male. The stone size ranged from 5 to 20 mm. The ureteral sites of the stones were distal in 21, middle in 12 and proximal in 9.Results: Considering stones with distal location in the ureter, 1 patient had ureteral perforation and developed a stricture in the follow-up (4.7%). As for stones in the middle ureter, 2 perforations and 1 stricture were observed (8.3%) and regarding stones located in the proximal ureter, 5 perforations and 4 strictures occurred (44%). In the mid ureter, 1 ureteral avulsion was verified. In 34 patients without ureteral perforation, only 1 developed a stricture (2.9%). Of 8 patients who had perforation, 6 developed strictures. The overall incidence of stricture following treatment of impacted ureteral calculi was 14.2%. Conclusions: Ureteroscopy for impacted ureteral calculi is associated with a higher incidence of ureteral perforation and stricture. Ureteroscopy of proximal ureteral calculi is associated with a high risk of perforation, when compared to mid or distal ureteral calculi. Ureteral perforation at the site of the stone seems to be the primary risk factor for stricture formation in these cases.

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“…ESWL for an unstented impacted ureteral stone is often unsuccessful. Ureteroscopic techniques present higher success rates since stones can be basketed, fragmented or pushed up to the kidney for ESWL [1,2]. Open or laparoscopic ureterolithotomy is still necessary in some cases of obstinate ureteral stones when less-invasive methods fail [3,4].…”

Section: Introductionmentioning

confidence: 99%

Management and Follow-Up of Impacted Ureteral Stones

et al. 2003

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Introduction: Impacted stones are those that remain unchanged in the same location for at least 2 months. Materials and Methods: We evaluated 42 patients with impacted ureteral stones, and followed them for two and a half years to check for long-term results. The calculi location included all three segments of the ureter (proximal, mid and distal). Patients’ age ranged from 22 to 83 years (mean 52.5 years). Primarily, patients were manipulated with extracorporeal shock wave lithotripsy (ESWL) in situ, or following stenting. If the result was not satisfactory, then we proceeded to retrograde ureteroscopy and ureterolithotripsy. Open ureterolithotomy was our final choice. Results: Thirty-six of the 42 patients (85.7%) were stone-free without the need of an open procedure. Follow-up period ranged from 10 up to 40 months, with a median period of 30 months and was achieved in 30 patients (71.4%). Stone recurrence was noted in 4 cases, while hydronephrosis without evidence of stone presence in 2. Conclusions: The initial approach for the treatment of impacted lithiasis should be attempted by ESWL. If this fails, alternative therapeutic solutions such as endoscopy can result in removal of the stone.

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Management of Upper Ureteral Calculi with Extracorporeal Shock wave Lithotripsy

Cited by 155 publications

References 9 publications

Management of Ureteral Stones by Extracorporeal Shock Wave Lithotripsy

Management of Ureteral Stones by Extracorporeal Shock Wave Lithotripsy

Ureteroscopic pneumatic lithotripsy of impacted ureteral calculi

Management and Follow-Up of Impacted Ureteral Stones

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