Extracorporeal Shockwave Lithotripsy of Distal Ureteral Calculi

Extracorporeal Shock Wave Lithotripsy for the treatment of ureteral stones : a Critique on Success rate

“…Interestingly, a considerable number of our considered patients with the urinary calculi in the lower segment of their ureters. Many prior studies have reported that calculi located in the lower ureter are refractory to SWL (Miller et al, 1986;Skolarikos et al, 2006). However, our observed success rate was higher than reports of some other studies.…”

“…Like other studies, no other ancillary procedures such as DJ stenting were required for our subjects (Mobley et al, 1994;Ashraf et al, 2010). Various studies have reported a success rate of 78-86.7% for renal and 84.2-88.7% for ureteric stones (Skolarikos 2006;Miller 1986). Ghimire (2012) reported a success rate of 96% for solitary stones which resemble our interpretations.…”

Treatment of Distai Ureteral Calculi with Extracorporeal Shock Wave Lithotripsy Experience with 264 Cases

“…With increasing experience in the applica tion of ESWL, attempts have been made to approach distal ureteral calculi with this method. After relatively unconvincing initial results [4], encouraging results could be registered by various authors [1,6,10]. How ever, these were based on patient numbers which were still small: 17, 39 and 43 cases, respectively.…”

“…The couch, which is not designed for treatment in the distal segment of the ureter, must be slightly modified for ESWL of prevesical calculi and the patient must be positioned on the couch in a special way. ESWL becomes possible in that the patient is positioned either in the sitting position [6,7] or, as is preferred in our hospital, in an extremely flat position [10], The shock waves are applied to the stones transgluteally and parasacrally from dorsal in both cases. As a rule the calculi are located at least on one image amplifier in the projection to the pelvic skeleton.…”

“…Distal ureteral calculi are primarily approached using ureteroendoscopy by most authors [3,5,9,11], With increasing experience, ESWL of distal ureteral calculi has gained importance [1,4,6,7,10,12]. In the following, our own experience with ESWL in this region of the ureter is analyzed in 264 patients.…”