Pneumatic lithotripsy for large ureteral stones: is it the first line treatment?

Abstract

Although SWL is generally accepted as the first treatment option for ureteral stones because of its non-invasive nature, PL with ureteroscopy seems to be a good alternative with the advantage of higher success rates and quick stone clearance. Especially when we take the importance of quick stone removal into account for larger ureteral stones, which are more likely to have obstruction, impaction, or infection, we believe that PL may be chosen as the first line treatment rather than SWL for stones larger than 10 mm.

Is Ureteral Catheterization Necessary after Ureteroscopic Lithotripsy for Uncomplicated Upper Ureteral Stones?

“…[1][2][3] The ureteroscopic procedure itself often has little impact on the patient's quality of life, but the method of ureteral drainage after the procedure may have a significant effect on the patient's quality of life. 4 The placement of a ureteral stent after ureteroscopy (URS) is recommended to relieve postoperative pain secondary to postoperative edema, to provide urinary flow from the kidney to the bladder, and to prevent late complications such as stricture.…”

Factors Affecting the Complications of Pneumatic Lithotripsy for the Treatment of Ureteral Stones with Different Localizations: A Multivariate Analysis of Complications

“…The well-known complications of the procedure range from postoperative fever to extensive ureteral stenosis requiring major reconstructive procedures. The overall complication rates of URS range widely, from 4 to 28.4% [1,2,3,4,5,6,7]. Nevertheless, despite a decreasing trend over time, URS still results in complications.…”

Use of XenX™, the latest ureteric occlusion device with guide wire utility: results from a prospective multicentric comparative study

“…Even though in some series the use of endoscopic lithotripsy with Holmium-YAG laser has increased the stonefree rates [3,11], the risk of stone fragments migration into the kidney is still present, especially in the case of stones in the upper ureter [1][2][3][4][5].…”

“…Retropulsion rates of stones or clinically significant fragments requiring ancillary procedures have been reported ranging from 2 to 40 %, with highest rates related to ureteric stones in proximal ureter and of more than 10 mm in size [1][2][3][4][5].…”