Extracorporeal Shock Wave Lithotripsy for Obstructed Proximal Ureteral Stones

Chang, Shi-Chung; Kuo, Hann‐Chorng; Hsu, Tsi

doi:10.1159/000474290

Cited by 25 publications

(7 citation statements)

References 30 publications

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“…Considering all its other advantages, and being the least invasive procedure, urgent in situ ESWL appears to be the preferred treatment option. A similar conclusion was reached by Chang et al [ 8] for upper ureteric stones causing varying degrees of obstruction.…”

Section: Discussionsupporting

confidence: 85%

“…Along with the physical properties of the stone, e.g. size and composition, the degree of obstruction is an important factor which determines the success of fragmentation [ 8, 9]. The two main treatment objectives are relief of obstruction, with the treatment of sepsis if present, and disintegration or removal of the stone.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, there are doubts about its efficacy in decompressing the kidney when compared with a nephrostomy [ 13]. The presence of the stent may hinder the passage of stone fragments [ 8, 13, 17].…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, although stenting gave better success rates than a PCN, the results were no better than in situ ESWL alone. It is probable that the presence of a stent resulted in a reduction of the shock‐wave energy reaching the stone [ 8], with a resultant decrease in efficiency. Furthermore, the presence of a stent has been shown to cause ureteric constriction [ 8] and oedema of the wall [ 4], both of which may reduce the chance of successful fragmentation or the passage of fragments after ESWL.…”

Section: Discussionmentioning

confidence: 99%

“…It is probable that the presence of a stent resulted in a reduction of the shock‐wave energy reaching the stone [ 8], with a resultant decrease in efficiency. Furthermore, the presence of a stent has been shown to cause ureteric constriction [ 8] and oedema of the wall [ 4], both of which may reduce the chance of successful fragmentation or the passage of fragments after ESWL. In the present study, more patients in group 2 required three or more sessions of ESWL than in group 1 and 2, providing further support to the view that the presence of a stent may reduce the efficacy of ESWL.…”

Section: Discussionmentioning

confidence: 99%

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A comparative analysis of nephrostomy, JJ stent and urgent in situ extracorporeal shock wave lithotripsy for obstructing ureteric stones

1999

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Objectives To determine the optimal method of treatpreference or the availability of urgent ESWL. The success rate was measured by the disintegration of ment for ureteric stones causing complete obstruction, treated by insertion of a JJ stent or a nephrostomy the stone and spontaneous passage after ESWL; failure was defined as the need for additional procedure(s) for tube, followed by extracorporeal shock wave lithotripsy (ESWL) or by urgent in situ ESWL if readily stone extraction. Results Urgent in situ ESWL (group 3) had a median available.Patients and methods The study comprised a retrospec-(95% confidence interval) success rate of 81 (54-96)%, compared with 70 (53-83)% in group 2 tive analysis of 82 consecutive patients who presented with ureteric stones causing complete obstruction.and 54 (33-73)% in group 1. Conclusion If facilities are available, urgent in situ ESWL Twenty-six had a percutaneous nephrostomy (PCN, group 1) and 40 had a JJ stent (group 2) placed to appears to be the choice of treatment for obstructing ureteric stones. If such facilities are not available, a relieve the obstruction, and the stones were subsequently treated by ESWL. Sixteen patients under-JJ stent may oCer better success than a PCN. A prospective controlled trial is necessary to confirm went urgent in situ ESWL without recourse to either a JJ stent or a PCN (group 3). The choice of the these findings.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%