Ureteroscopic Treatment of Lower Ureteral Calculi in the Era of Extracorporeal Shock Wave Lithotripsy: From a Developing Country Point of View

Chang, Shi-Chung; Ho, Chak-Man; Kuo, Hann‐Chorng

doi:10.1016/s0022-5347(17)35788-9

Cited by 34 publications

(10 citation statements)

References 24 publications

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“…For patients with non–impacted stones, 23 (96%) were rendered stone–free, thus, stone–free rate in URS for lower ureteric stones is not affected by stone impaction the way it is in ESWL. Chang et al 2001 [22] had similar findings and concluded that URS was the best choice in selected patients who had stones >10 mm in size with evidence of impaction and severe colicky pain.…”

Section: Discussionmentioning

confidence: 90%

Management of lower ureteric stones: a prospective study

Etafy

Morsi

Beshir

et al. 2013

CEJU

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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.

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Section: Discussionmentioning

confidence: 90%

Management of lower ureteric stones: a prospective study

Etafy

Morsi

Beshir

et al. 2013

CEJU

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“…12,15 It is recommended only if the stone cannot be managed with either ESWL or standard retrograde ureteroscopic technique. In our hospital, the success rate for mid-ureteric stones was 92.3%, which is similar to that for stones in the upper one-third of the ureter.…”

Section: Discussionmentioning

confidence: 99%

“…Depending on the availability of the equipment and expertise, one or the other therapy is given the priority. The success rate for ESWL treatment of distal ureteral calculi varies from 53%-96%, [14][15][16] and re-treatment rate varies from 10%-30%. 17 The clearance rate for distal ureteral stones treated with ESWL is significantly affected by the stone size.…”

Section: Discussionmentioning

confidence: 99%

“…Added to this is the fact that it has a 0.5%-10% complications rate. 15,19 However, the availability of new ureteroscopes with better optics and smaller diameter has made it possible to carry out the procedure without any anesthesia. The smaller diameter scopes also do not require ureteral orifice dilation, so there is a decrease in long-term complications, with the result that postoperative indwelling stents are no longer needed.…”

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confidence: 99%

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Extracorporeal Shock Wave Lithotripsy in the Treatment of Ureteric Stones: Experience from Tawam Hospital, United Arab Emirates

Ghafoor

Halim

2002

Ann Saudi Med

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Background:The optimal treatment of ureteric stones, especially the lower ureteric stone, remains controversial. The purpose of this study was to evaluate the role of extracorporeal shock wave lithotripsy (ESWL) in the management of ureteric stones. Materials and Methods: A total of 99 patients with ureteric stones at different levels were treated with ESWL from 1994 through 1998 at our hospital. All patients were treated using Siemen Lithostar-II Plus Lithotripter. Of the 99 patients, 20 were excluded from the study because they had no follow-up records of their stone-free status. The clearance rates for ureteric stones of the other 79 patients treated were stratified according to the site, size, and number of treatment sessions required per stone. The stone size was determined by the widest diameters. Based on stone size, the patients were divided into two groups: A (≤10 mm) and B (11-20 mm). Results: The overall clearance rate for ureteric stones treated with ESWL, irrespective of its site and size, was 78.5%. The overall clearance rate for size A (≤10 mm) stones was 82% and size B (11-20 mm) was 58% regardless of the site of the stone in the ureter. A total of 17 upper ureteric stones were treated with ESWL. The overall clearance rate for upper ureteric stones was 94%. Thirteen patients with mid-ureteric stones were treated with ESWL. The overall clearance rate for the mid-ureteric stones was 92.3%. Forty-nine patients had lower ureteric stones. The overall clearance rate for the lower ureteric stones was 69.3%. Conclusions: ESWL is safe, effective, noninvasive and a convenient way of treatment for all ureteric stones. The clearance rate for stones in the upper and mid-ureter is above 90%. ESWL being an outpatient procedure without any need for anesthesia or any pretreatment intervention, it should be considered as the first line of treatment for all stones in the upper and mid-ureter. The clearance rate for small stones (≤10mm) in the lower third of the ureter was 73.8% in our study and for these, ESWL may be considered as a primary therapy. For stones larger than 10 mm in the distal third of ureter, the clearance rate was low with a high retreatment rate, and ureteroscopy as primary treatment modality would be more preferable. Ann Saudi Med 2002,-22(1-2) The current management of upper urinary tract calculi is based on stone fragmentation into smaller pieces which are allowed to pass spontaneously, or removed with an endoscope. To achieve this, energy should be transferred to the stone either percutaneously (extracorporeal shock wave lithotripsy) or through an endoscope (intracoporeal lithotripsy). Chaussy et al. in 1980 was the first to report the clinical application of shock wave lithotripsy in the management of kidney stones, and since then the management of nephrolithiasis has undergone a complete revolution.1 Recent technological developments have resulted in more advanced lithotripters with shorter focal length and more narrow focal breadth, which help reduce the level of pain and ultimately obviate...

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“…Ayrıca ESWL'de taşsızlık konumuna ulaşıncaya kadar daha fazla uygulama ve takip zamanı gerekmektedir (10). Üreter alt uç taşlarının ESWL ile tedavisinde taşsızlık oranı %53-96 gibi geniş bir değişkenliğe sahiptir (1,11,12). Ertürk ve ark.…”

Section: -----------------üReter Alt Uç Taşlarinin Tedavi̇si̇nde Eswl Vunclassified

Üreter Alt Uç Taşlarının Tedavisinde ESWL ve Üreteroskopi'nin Karşılaştırılması

Çağatay;BEDÜK¹

2003

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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Ureteroscopic Treatment of Lower Ureteral Calculi in the Era of Extracorporeal Shock Wave Lithotripsy: From a Developing Country Point of View

Cited by 34 publications

References 24 publications

Management of lower ureteric stones: a prospective study

Management of lower ureteric stones: a prospective study

Extracorporeal Shock Wave Lithotripsy in the Treatment of Ureteric Stones: Experience from Tawam Hospital, United Arab Emirates

Üreter Alt Uç Taşlarının Tedavisinde ESWL ve Üreteroskopi'nin Karşılaştırılması

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