Electrohydraulic Versus Pneumatic Disintegration in the Treatment of Ureteral Stones: A Randomized, Prospective Trial

Hofbauer, J.; Höbarth, K.; Marberger, Michael

doi:10.1016/s0022-5347(01)67667-5

Cited by 60 publications

(29 citation statements)

References 24 publications

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“…URSL achieves a high success rate for ureteral stone especially when ureteroscope is becoming thinner and more flexible and different lithotripters are available such as electrohydraulic lithotripsy, pneumatic lithotripsy, and various kinds of lasertripsy [16,17] . Grasso et al [18] demonstrated that flexible ureteroscope and holmium:YAG laser in treating large upper urinary calculi had a high success rate.…”

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness of Treating Ureteral Stones in a Taipei City Hospital: Shock Wave Lithotripsy versus Ureteroscopy plus Lithoclast

Huang¹,

Chen²,

Chen

2009

Urol Int

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Aim: To compare cost-effectiveness, success rates and sat isfaction score of ureteroscopic lithotripsy with lithoclast (URSL) and extracorporeal shock wave lithotripsy (ESWL) for ureteral stones in a Taipei City Hospital. Methods: This is a retrospective study. From July 1998 to June 2000, 448 patients who underwent treatment for ureteral stones were included. The patients were divided into two treatment groups according to the initial method adopted for the management of their stone. Medical records and hospital financial records were collected for costs of implementing each treatment program. The satisfaction scores of patients (rating from 0 to 10) were collected by telephone interviews. Success was defined as complete clearance of the stone or fragmentation of stones smaller than 2 mm by plain abdominal film and complete relief of symptoms after initial treatment. Results: A total of 360 patients were in the ESWL group (including 144 upper, 48 middle and 168 lower third stones) and 88 in the URSL group (including 28 upper, 24 middle and 36 lower third stones). The range of stone size was from 0.6 to 1.9 cm. The overall treatment cost was comparable in both groups with a trend for it to be higher in the ESWL group without reaching statistical significance (TWD 20,901.5 ± 8,911.3 vs. 19,876.1 ± 4,782.2). Stratified by the location of stone, the overall treatment cost was significantly higher in the ESWL group than in the URSL group for patients with upper third ureteral stones irrespective of stone size. The efficiency quotient for ESWL and URSL was 0.62 and 0.65, respectively. The success rate was significantly higher in the URSL group than in the ESWL group (89.8 vs. 71.7%). Satisfaction scores were similar for both groups with a trend to be higher in the ESWL group without reaching statistical significance (7.97 ± 1.01 vs. 7.53 ± 1.37). Conclusions: The overall treatment cost of patients with upper third ureteral stone was significantly higher in the ESWL group than in the URSL group, but the success rate was significantly higher in the URSL group than in the ESWL group.

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Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness of Treating Ureteral Stones in a Taipei City Hospital: Shock Wave Lithotripsy versus Ureteroscopy plus Lithoclast

Huang¹,

Chen²,

Chen

2009

Urol Int

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“…Thus the occurrence of vesicoureteral reflux or ureteral stricture that can accompany dilation of ureter to a nonreversible diameter was avoided [18][19][20]. The pulsed dye laser is transmitted through a thin and flexible quartz fiber and can be used through the channel of this ureteroscope [21,22]. However, the fine fiber often causes bleeding when it sticks to the ureteral wall where the stone is impacted and covered with edematous mucous membrane.…”

Section: Discussionmentioning

confidence: 99%

Transurethral Ureterolithotomy in 100 Lower Ureteral Stones

Hamano¹,

Tanaka²,

Suzuki³

et al. 1998

Urol Int

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A total of 100 patients with lower ureter stones received transurethral ureterolithotripsy (TUL) using a pulsed dye laser and/or a pneumatic lithotriptor. Extracorporeal shock wave lithotripsy treatment was added in 15 patients because fragments larger than 4 mm had been pushed back to the renal pelvis. The median stone size was 8 mm (range 3–22 mm). Operative time ranged between 3 and 157 min with a median of 30 min. Stone size correlated well with impaction, when impaction was defined as the inability of a guidewire to pass over the stone. Complete removal was defined as total clearance at 1 month without retreatment. The overal stone-free rate was 93%. Among the 7 not-stone-free cases, 5 cases were considered to have been treated successfully because asymptomatic residual fragments were smaller than 4 mm, 1 case required retreatment to become stone free, and 1 case with a silent residual fragment of 8 mm had been followed up for 3 months. The success rate was 98% when successful treatment was defined as total clearance or the presence of asymptomatic residual fragments of 4 mm or less without retreatment. Impaction was not a significant determining factor of stone-free rate (95.7 and 86.7%, respectively, p >0.05) and in situ stone-free rate (TUL alone; 85.7 and 76.7%, respectively, p >0.05). Two minor ureteral perforations were encountered. No patient required percutaneous nephrostomy or open surgery, or showed any late complications. TUL is a safe and successful method in managing lower ureteral stones.

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“…Dagegen ist die elektrohydraulische Lithotripsie in allen miniaturisierten und flexi- blen Ureteroskopen einsetzbar und fragmentiert auch Kalziumoxalat-MonohydratSteine wirksam und schnell [7,8,14].Bei impaktierten Steinen birgt eine schlecht kontrollierbare Energieentfaltung das konsekutive Risiko einer Harnleiterläsion [14].Ein weiteres attraktives, da kostengünstiges und effektives Verfahren mit breiter Einsatzmöglichkeit und wiederverwendbaren Sonden sind die pneumatischen bzw. ballistischen Lithotriptoren [14,15,16,23].Nachteilig bei Inkompatibilität mit flexiblen Ureteroskopen [8,16] scheint ein hohes Risiko der Steinreposition v. a. in dilatierten Systemen bei proximalen Uretersteinen zu sein [15,16], weshalb zur Reduktion der proximalen Steinmigration der sog.…”

Section: Elektrohydraulische Lithotripsieunclassified

“…ballistischen Lithotriptoren [14,15,16,23].Nachteilig bei Inkompatibilität mit flexiblen Ureteroskopen [8,16] scheint ein hohes Risiko der Steinreposition v. a. in dilatierten Systemen bei proximalen Uretersteinen zu sein [15,16], weshalb zur Reduktion der proximalen Steinmigration der sog. Lithovac eingeführt wurde [6,13] [10,12,21,26].…”

Section: Elektrohydraulische Lithotripsieunclassified

Der frequenzverdoppelte Doppelpuls-Neodym:YAG-Laser (FREDDY) bei Urolithiasis

et al. 2003

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Laser lithotripsy does not play an important role in urinary stone treatment, mostly due to ineffective fragmentation efficiency, and high purchase and maintenance costs. The aim of the following retrospective study was to show the clinical significance and efficiency of an innovative laser lithotripsy system for urinary stone treatment. Between November 1998 and October 1999, 48 patients were treated with the innovative frequency- doubled double-pulse Neodym: YAG laser lithotripter FREDDY. A total of 50 renal units were treated, 43 ureteroscopically, four ureterorenoscopically, three percutaneous-nephroscopically, and one bladder stone cystoscopically. With a median laser operation time of 5 min (range: 1-30 min) and a total procedure duration of 60 min (range: 15-180 min), a stone-free rate of upper ureteral stones of 62%, middle ureteral stones of 91% and distal ureteral stones of 100% were documented on the first day after treatment. In an observation period of 6 months, no complications were seen. In our experience Laser lithotripsy with FREDDY is an effective, simple and reliable method for the treatment of ureteral stones, with low purchase and maintenance costs. The extremely thin and highly flexible quartz fibre may extend the endoscopic spectrum to otherwise poorly accessible upper ureteral stones, the renal pelvis and renal calix stones. Therefore, a prospective validation study for comparison with ballistic lithotriptors is of great interest.

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Electrohydraulic Versus Pneumatic Disintegration in the Treatment of Ureteral Stones: A Randomized, Prospective Trial

Cited by 60 publications

References 24 publications

Cost-Effectiveness of Treating Ureteral Stones in a Taipei City Hospital: Shock Wave Lithotripsy versus Ureteroscopy plus Lithoclast

Cost-Effectiveness of Treating Ureteral Stones in a Taipei City Hospital: Shock Wave Lithotripsy versus Ureteroscopy plus Lithoclast

Transurethral Ureterolithotomy in 100 Lower Ureteral Stones

Der frequenzverdoppelte Doppelpuls-Neodym:YAG-Laser (FREDDY) bei Urolithiasis

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