Electrohydraulic Lithotripsy: An Effective and Economical Modality of Endoscopic Ureteric Lithotripsy

See, A. C. H.; Ng, Foo Cheong; Chng, H. C.

doi:10.1111/j.1445-2197.1997.tb02036.x

Cited by 9 publications

(6 citation statements)

References 9 publications

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“…Ureteroscopic fragmentation of ureteral stones by use of intracorporeal lithotripsy is a popular, effective, minimally invasive technique and is considered to be the treatment of choice for lower ureteral stones [5]. Previous studies have reported success rates ranging from 72 to 100% [4,5,14,15], which is similar to the success rate in our study for patients who were treated by URS with EHL (98.5%).…”

Section: Discussionsupporting

confidence: 86%

“…EHL has been widely used for endoscopic treatment of urinary stones since its introduction by Yutkin in 1955 (quoted from [5,6]). Green and Lytton [16] reported their experience with EHL of ureteral stones with the use of a rigid ureteroscope and a 5-Fr EHL probe.…”

Section: Discussionmentioning

confidence: 99%

“…EHL was attempted in 1955 by Yutkin and was the first technique developed for intracorporeal lithotripsy (quoted from [5,6]). In recent years, the development of a new lithotriptor using a holmium: yttrium aluminum garnet (YAG) laser has increased the efficacy of URS for the treatment of ureteral stones.…”

Section: Introductionmentioning

confidence: 99%

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Influence of Ureteral Stone Components on the Outcomes of Electrohydraulic Lithotripsy

et al. 2012

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PurposeWe evaluated the influence of urinary stone components on the outcomes of ureteroscopic removal of stones (URS) by electrohydraulic lithotripsy (EHL) in patients with distal ureteral stones.Materials and MethodsPatients with a single distal ureteral stone with a stone size of 0.5 to 2.0 cm that was completely removed by use of EHL were included in the study. Operating time was defined as the time interval between ureteroscope insertion and complete removal of ureteral stones. Ureteral stones were classified into 5 categories on the basis of their main component (that accounting for 50% or more of the stone content) as follows: calcium oxalate monohydrate (COM), calcium oxalate dihydrate, carbonate apatite (CAP), uric acid (UA), and struvite (ST).ResultsA total of 193 patients (131 males and 62 females) underwent EHL. The mean operating time was 25.1±8.2 minutes and the mean stone size was 1.15±0.44 cm. Calcium oxalate stones accounted for 64.8% of all ureteral stones, followed by UA (19.7%), CAP (8.3%), and ST (7.2%) stones. The mean operating time was significantly longer in the UA group (28.6±8.3 minutes) than in the COM group (24.0±7.8 minutes, p=0.04). In multivariate analyses, the stone size was negatively associated with the odds ratio (OR) for successful fragmentation. UA as a main component (OR, 0.42; 95% confidence interval, 0.20 to 0.89; p=0.023) was also found to be significantly important as a negative predictive factor of successful fragmentation after adjustment for stone size.ConclusionsThe results of the present study suggest that successful fragmentation by URS with EHL could be associated with the proportion of the UA component.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

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Influence of Ureteral Stone Components on the Outcomes of Electrohydraulic Lithotripsy

et al. 2012

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“…Minor complications also are uncommon and include minimal mucosal lesions (eg, petechiae and erosions) that do not appear to be clinically relevant. 8,10,[15][16][17][18][19] To our knowledge, evaluation of the efficacy of EHL has not been examined in dogs with spontaneously occurring bladder calculi. The purpose of this study was to evaluate the efficacy and safety of EHL in the fragmentation of bladder and urethral calculi in dogs.…”

mentioning

confidence: 99%

Use of Electrohydraulic Lithotripsy in 28 Dogs with Bladder and Urethral Calculi

Defarges

Dunn

2008

Veterinary Internal Medicne

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Background: Electrohydraulic lithotripsy (EHL) has been used as an alternative to cystotomy in human medicine to remove urinary calculi. This prospective study evaluated the efficacy and safety of EHL to remove urinary calculi in dogs.Hypothesis: EHL is an efficient and safe method of treatment of bladder and urethral calculi in dogs. Methods: Dogs presented between January 1, 2005 and June 1, 2007 with lower urinary tract calculi diagnosed by radiographs or ultrasound examination were included in the study. Physical examination, CBC, biochemistry, urinalysis, and urine culture were performed at presentation. EHL and voiding urohydropulsion were performed under general anesthesia. Patients received IV fluids for 12 hours after which they were rechecked by ultrasound examination and discharged with antibiotics and anti-inflammatory drugs for 5 days. All patients were reevaluated 1, 3, and 6 months after presentation by physical examination, urinalysis, and ultrasonography.Results: Twenty-eight dogs (19 males, 9 females) presented with bladder or urethral calculi or both underwent lithotripsy. Their median weight was 8.3 kg. Calcium oxalate calculi were present in 22 dogs, struvite in 4, and mixed calculi in 2. Fragmentation was done in the bladder (23 dogs) and in the urethra (12 dogs). Calculus-free rate was higher for urethral than for bladder calculi in males and higher for bladder calculi in females than in males. No major complications were reported. Twelve dogs relapsed within 6 months.Conclusions: Results of this study support the use of EHL as a minimally invasive treatment for bladder calculi in females and for urethral calculi in male dogs.

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“…In this study, the rate of major ureteric perforation was 1% using a rigid ureteroscope, while in other published studies the rates were 2% using semirigid ureteroscopes, 11.2% with rigid ureteroscopes, and 4.5% when electrohydraulic lithotripsy was used during ureteroscopy. 7,13,14,[19][20][21][22][23] The rate of mucosal injury in this study was 2% while it was 6.1% with the use of a semirigid ureteroscope in another study. 20 In this study, the morbidity rates were better than those reported in some published studies.…”

Section: Discussionmentioning

confidence: 93%

Morbidity associated with surgical treatment of ureteric calculi in a teaching hospital in Kuwait

Kehinde

Al-Awadi

Al-Hunayan

et al. 2003

ann r coll surg engl

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Background: Ureteric lithiasis is a common urological problem in Kuwait. Because of the different interventional approaches, we carried out an audit on the morbidity associated with the surgical management of the disorder. Patients and Methods:The surgical records were reviewed of all patients with the diagnosis of ureteric lithiasis that were managed surgically by ureteroscopy or ureterolithotomy in Mubarak AlKabeer Hospital in Kuwait between January 1996 and December 1999. Patients' bio-data, location of calculi, indications for surgical intervention, types of therapeutic interventions, operating surgeon and complications were analysed. Patients managed primarily and successfully by extracorporeal shockwave lithotripsy were excluded from this analysis. Results: A total of 1383 patients with ureteric calculus were managed in the period under review -775 (56%), 567 (41%), and 41 (3%) patients were managed by extracorporeal shockwave lithotripsy, ureteroscopy and ureterolithotomy, respectively. The 608 patients managed by ureteroscopy or ureterolithotomy had a total of 710 operations. The commonest surgical procedure performed was ureteroscopy with Dormia basket with or without double 'J' stenting and this accounted for 418 (58.9%) operations. The least common procedure was ureteric meatotomy with Dormia basket and with or without double 'J' stenting in 9 (1.3%) patients. The overall complication rate was 110 out of 710 (15.5%) operations. Of the complications, 101 (92%) were minor ( e.g. haematuria, fever, and mucosal injury). Nine (8%) complications were major complications ( e.g. ureteric perforation and ureteric avulsions). Ureterolithotomy and ureteroscopy with intracorporeal lithotripsy were associated with the highest complication rates. Conclusions: This analysis has shown that with technological advances, the treatment of ureteric lithiasis has improved and major complications have decreased. However, with so many therapeutic options to choose from, there is a need to audit the various therapeutic options and select those associated with the least morbidity rates in each urology unit.

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Electrohydraulic Lithotripsy: An Effective and Economical Modality of Endoscopic Ureteric Lithotripsy

Cited by 9 publications

References 9 publications

Influence of Ureteral Stone Components on the Outcomes of Electrohydraulic Lithotripsy

Influence of Ureteral Stone Components on the Outcomes of Electrohydraulic Lithotripsy

Use of Electrohydraulic Lithotripsy in 28 Dogs with Bladder and Urethral Calculi

Morbidity associated with surgical treatment of ureteric calculi in a teaching hospital in Kuwait

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