Clinical outcome of ureteroscopic lithotripsy for 2,129 patients with ureteral stones

Kurahashi, Toshifumi; Miyake, Hideaki; Oka, Noriko; Shinozaki, Masashi; Takenaka, Atsushi; Hara, Isao; Fujisawa, Masato

doi:10.1007/s00240-007-0095-3

Cited by 16 publications

(11 citation statements)

References 13 publications

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“…Actually, on reviewing our last 200 cases of ureteroscopic stone extraction, the success rate was 100%; this is attributable to the learning curve and accumulation of experience with ureteroscopy, the availability of small rigid and semirigid ureteroscopes, and the Lithoclast and laser lithotripters that are highly efficient and economical instruments for stone fragmentation. The present results are compatible with those reported by others [4,11–15].…”

Section: Discussionsupporting

confidence: 94%

Ureteroscopic management of lower ureteric calculi: a 15‐year single‐centre experience

et al. 2008

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OBJECTIVE To review our 15‐year experience with ureteroscopic treatment of distal ureteric calculi and to determine the impact of improved technology and techniques on the efficacy, success and complications of the procedure. PATIENTS AND METHODS We retrospectively reviewed the medical records of 4512 patients who underwent 5133 ureteroscopic procedures for the treatment of distal ureteric calculi at our institution from January 1991 to December 2005. The patient and stone characteristics, treatment variables and clinical outcomes were assessed. Factors such as type of ureteroscope, procedure duration, procedure success, complication rate and hospital stay were evaluated. Data obtained from a cohort of patients that underwent the procedure from 1991 to 1995 (group 1) were statistical compared with those obtained from a cohort of patients from 1996 to 2005 (group 2). Logistic regression analysis was used to identify associated factors with the major complications of ureteroscopy. RESULTS Overall, the stone‐free rate after the procedure was 94.6%, the mean (sd; range) operative duration was 43 (15.0; 25–120) min, the intraoperative complication rate was 6.67%, the postoperative complication rate was 9.9%, and the mean (sd) hospital stay was 1.7 (1.1) days. The clinical and radiological follow‐up (mean 36.8 months) for 71.3% of eligible patients detected only 12 ureteric strictures (0.23%). On comparing group 1 with group 2, the overall success of ureteroscopic stone extraction improved from 85.7% to 97.3% (P < 0.001), significant ureteric perforation decreased from 3.3% to 0.5% (P = 0.05), ureteric avulsion decreased from 1.3 to 0.1% (P < 0.05), ureteric stricture decreased from 0.7% to 0.1% (P < 0.007), the mean (sd) procedure time significantly decreased from 75 (42.9) min to 36.5 (12.5) min (P < 0.001), and the mean hospital stay significantly decreased from 2.5 (1.6) days to 0.5 (1.2) days, with a trend toward outpatient treatment. Logistic regression analysis showed a significant association of the major ureteroscopic complications with increased operative duration, type of ureteroscope used, stone impaction, stone size and surgeon experience. CONCLUSION The present series shows the high success rate, with minor complications, that can be achieved with ureteroscopic treatment of distal ureteric calculi. Improvements in ureteroscope design, accessories, technique and experience have led to a significant increase in the success rate and decrease in the complication rate.

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Section: Discussionsupporting

confidence: 94%

Ureteroscopic management of lower ureteric calculi: a 15‐year single‐centre experience

et al. 2008

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“…This process prolongs the time required for the procedure and increases the amount of ionizing radiation to the patient. The reported stone-free rate following a single treatment with USL ranges from 73.3% in a large scale study (10) to 89.4% in a small study (8). According to a large scale study, ureteral perforation requiring surgical correction occurred in 0.65% (10).…”

Section: Discussionmentioning

confidence: 99%

“…The reported stone-free rate following a single treatment with USL ranges from 73.3% in a large scale study (10) to 89.4% in a small study (8). According to a large scale study, ureteral perforation requiring surgical correction occurred in 0.65% (10). USL could be a safe and effective treatment option for ureteral stones; however, other therapeutic strategies should also be considered in patients with currently identified risk factors associated with treatment failure following a single USL procedure.…”

Section: Discussionmentioning

confidence: 99%

Ureteroscopic Lithotripsy Using Swiss Lithoclast for Treatment of Ureteral Calculi: 12-Years Experience

Hong

Park

2009

J Korean Med Sci

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Ureteroscopic lithotripsy using Swiss Lithoclast was performed in 411 cases from January 1996 to September 2007 in a single hospital. Medical records of 341 cases, in which Swiss Lithoclast was successfully applied, were available for this retrospective study. We used 9.5Fr and 10Fr Storz rigid ureteroscopes. A success was defined as being free of stone-related symptoms and residual stones larger than 2 mm. Sixty one stones were located in the upper ureter, 49 stones were in the mid ureter, and 231 stones were in the lower ureter. The overall success rate was 93.5%. The success rate of upper ureter stone (80.3%) was significantly lower compared with those of mid (93.8%) and lower (96.9%) ureter stones (P=0.001). The higher the calculi was located within the ureter, the more chance of upward migration there was (P<0.001). The success rate in male patients was lower than in female patients without a statistical significance (P=0.068). The success rate decreased as the size of the stone increased (P<0.001), and as the degree of hydronephrosis increased (P=0.03). Perforation rates were 4.9%, 4.1%, and 2.6% from upper to lower ureter stone group. Ureteroscopic lithotripsy using Swiss Lithoclast is a safe and useful treatment modality for ureteral calculi.

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“…Furthermore, the stone clearance rate of ESWL was determined by stone composition and stone hardness. Holmium laser lithotripsy is a reliable method of stone disintegration irrespective of the stone composition and hardness, it is carried out through all types of ureteroscope [19], but stone migration will make operation failure [20], [21]. With the instrument development and operation skill promotion we still cannot avoid ureteroscopic lithotripsy failure.…”

Section: Discussionmentioning

confidence: 99%

Comparison of ESWL and Ureteroscopic Holmium Laser lithotripsy in Management of Ureteral Stones

et al. 2014

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BackgroundThere are many options for urologists to treat ureteral stones that range from 8 mm to 15 mm, including ESWL and ureteroscopic holmium laser lithotripsy. While both ESWL and ureteroscopy are effective and minimally invasive procedures, there is still controversy over which one is more suitable for ureteral stones.ObjectiveTo perform a retrospective study to compare the efficiency, safety and complications using ESWL vs. ureteroscopic holmium laser lithotripsy in management of ureteral stones.MethodsBetween October 2010 and October 2012, 160 patients who underwent ESWL or ureteroscopic holmium laser lithotripsy at Suzhou municipal hospital for a single radiopaque ureteral stone (the size 8–15 mm) were evaluated. All patients were followed up with ultrasonography for six months. Stone clearance rate, costs and complications were compared.ResultsSimilarity in stone clearance rate and treatment time between the two procedures; overall procedural time, analgesia requirement and total cost were significantly different. Renal colic and gross hematuria were more frequent with ESWL while voiding symptoms were more frequent with ureteroscopy. Both procedures used for ureteral stones ranging from 8 to 15 mm were safe and minimally invasive.ConclusionESWL remains first line therapy for proximal ureteral stones while ureteroscopic holmium laser lithotripsy costs more. To determining which one is preferable depends on not only stone characteristics but also patient acceptance and cost-effectiveness ratio.

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Clinical outcome of ureteroscopic lithotripsy for 2,129 patients with ureteral stones

Cited by 16 publications

References 13 publications

Ureteroscopic management of lower ureteric calculi: a 15‐year single‐centre experience

Ureteroscopic management of lower ureteric calculi: a 15‐year single‐centre experience

Ureteroscopic Lithotripsy Using Swiss Lithoclast for Treatment of Ureteral Calculi: 12-Years Experience

Comparison of ESWL and Ureteroscopic Holmium Laser lithotripsy in Management of Ureteral Stones

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