Large impacted upper ureteral calculi: A comparative study between retrograde ureterolithotripsy and percutaneous antegrade ureterolithotripsy in the modified lateral position

“…Patients undergoing UL had lower analgesic requirement, shorter hospital stay, and shorter interval to return to normal activities compared to the percutaneous approach. 19,20 In our study, the mean hospital stay was significantly lower in the UL group.…”

Section: Discussionmentioning

confidence: 57%

Minimally invasive surgical treatment for large impacted upper ureteral stones: Ureteroscopic lithotripsy or percutaneous nephrolithotomy?

Bozkurt

Yonguç

Arslan

et al. 2015

CUAJ

View full text Add to dashboard Cite

Introduction:The management of patients with large impacted upper ureteral stones is difficult; there is no standard treatment. We compared the outcomes of percutaneous nephrolithotomy (PCNL) and ureteroscopic lithotripsy (UL) to treat large (≥1.5 cm), impacted, upper ureteral stones. Methods: In total, 86 patients with large impacted upper ureteral stones were included in this study. Of these patients 41 underwent UL and 45 underwent PCNL. The inclusion criteria were: longest diameter of stone ≥1.5 cm, the localization of stone between the lower border of L4 spine and ureteropelvic junction and impacted stone. Results: In the UL group, we were unable to reach the stone in 3 patients because of ureteral stricture and edema despite balloon dilation. Of these 3 patients, we were unable to optimally visualize the stone in 2 patients due to bleeding and mucosal injury following balloon dilation. The stricture was too firm and could not be passed in the third patient. Also in the UL group, 15 patients had stones or big fragments which migrated into the renal collecting system. In the PCNL group, 21 patients had concurrent renal stones <1 cm and stones were successfully removed in all patients. No statistically significant difference was found between groups in terms of operation time. Mean hospital stay was significantly shorter in the UL group. Success rates were 82.3% in the UL group and 97.6% in the PCNL group (p = 0.001). Conclusion:The recent study confirms that PCNL is a safe and effective minimally invasive procedure with acceptable complication rates in the treatment of patients with large, impacted upper ureteral stones.

show abstract

“…Miniperc is excellent tool in these type of stones especially when stones are impacted [12,13]. Complete removal of the stone is the primary management goal in miniperc to relieve obstruction, eliminate infection, prevent further stone growth, and preserve renal function [14]. Impacted stones make it necessary to do stenting prior to ESWL [8].That makes it less acceptable in addition to low clearance rate [8].…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of Lithotripsy and Miniperc in 11 to 18 Mm Impacted Puj Calculi

Wankhade¹,

Khalkar²,

Ghule³

et al. 2018

IJCBR

View full text Add to dashboard Cite

Background: Impacted PUJ calculi are well known entity. Nephrolithiasis is a common disorder that accounts for significant cost, morbidity, and loss of work. Over last 3 decades considerable advances have been made in the management of kidney stone disease, still there is no single universally accepted and uniformly effective modality of treatment in medium size of impacted PUJ calculi. Aim: To study the efficacy of lithotripsy and MINIPERC in 11mm to 18mm impacted PUJ calculi. Methodology: The patients with impacted PUJ calculi of size 11 to 18mm of both sexes of all age group varying form 18-60 years, on consecutive sampling method total 84 patients were included. All patients underwent basic lab investigations, USG, IVU and investigations for fitness purpose. Group 1: All procedures were tubeless. We used 15 Fr Richard Wolf nephroscope for the procedure. 16 to 20 Fr Amplatz sheath was used depending upon situation. Fragmentation was performed using pneumatic lithoclast or holmium Laser depending upon stone size and characteristics. Group 2: Underwent DJ stenting under subarachnoid block or short GA depending upon situation. On the next day they were subjected for lithotripsy on Dorniel alpha machine under USG guidance, 3000 shocks were given in each sitting. One to three such sittings were given. Post operatively ultrasonography and X-ray KUB was done in all the patients and stents were removed after assuring complete clearance. Patients with absence of stone or presence of stone less than 4 mm on USG or x-ray KUB were declared as completely cleared. Results: Average hospital stay was 48 hours in miniperc group and it was 30 hours in DJ with ESWL group. Clearance rate was 100 % in Miniperc group and it was 85.71 % in DJ with ESWL group. Five patients (11.9%) in DJ lithotripsy group required another procedure. (Two needed miniperc and three needed URS). Two(4.76 %) patients in miniperc group had fever in post op period but nobody suffered major sepsis. Conclusion: Miniperc fulfils many criteria if we see results and complications. Although bigger sized multicentric study and long term follow up is needed.

show abstract

Large impacted upper ureteral calculi: A comparative study between retrograde ureterolithotripsy and percutaneous antegrade ureterolithotripsy in the modified lateral position

Cited by 38 publications

References 23 publications

Safety and efficacy of Mini-Percutaneous Nephrolithotomy in the treatment of large impacted Proximal Ureteral Stones

Safety and efficacy of Mini-Percutaneous Nephrolithotomy in the treatment of large impacted Proximal Ureteral Stones

Minimally invasive surgical treatment for large impacted upper ureteral stones: Ureteroscopic lithotripsy or percutaneous nephrolithotomy?

Comparative Study of Lithotripsy and Miniperc in 11 to 18 Mm Impacted Puj Calculi

Contact Info

Product

Resources

About