Primary Endoscopic Treatment of Ureteric Calculi

Puppó, P.; Ricciotti, G.; W, Bozzo; Introini, Carlo

doi:10.1159/000019926

Cited by 73 publications

(38 citation statements)

References 25 publications

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“…These results resemble those from current studies on electively scheduled URS, which range from 86.6% to 94.6% for all ureteral stones, increasing to 95.6% to 100% for distal ones. [13][14][15][16][17][18] Our study has some limitations, namely its retrospective design and that no comparison with a control group was done. Still, to our knowledge, this is the first report focusing on ureteroscopic management of ureteral stones in emergency situations.…”

Section: Commentmentioning

confidence: 99%

Emergency Ureteroscopic Management of Ureteral Stones: Why Not?

Osório

Lima

Soares

et al. 2007

Urology

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OBJECTIVESTo describe a single-center experience in the emergency ureteroscopic management of ureteral stones. METHODSWe retrospectively considered the data from 144 patients (mean age 49.6 years, range 23 to 82) who had had obstructive ureteral stones and had undergone emergency ureteroscopy with stone retrieval. Intracorporeal pneumatic lithotripsy was performed when necessary. At the end of the procedure, a ureteral catheter was systematically left in place in 100 patients (69.4%) and removed within 24 hours. In the remaining 44 patients, a double-J stent was preferred and was removed within 30 days, depending on the clinical course. Stone-free status was defined as the complete absence of fragments at 1 month of follow-up. RESULTSThe calculi were more frequently localized in the distal ureter than in the proximal one (90.3% versus 9.7%, respectively). The overall mean stone diameter was 9.1 mm (range 5 to 20). The overall stone-free rate was 92.4%. A greater stone-free rate was obtained in those with stones less than 10 mm (95.8%) than in those with stones larger than 10 mm (89%, P ϭ 0.002). Similarly, a significantly better outcome occurred for those with stones located in the distal ureter (94.6%) than for those with stones in the proximal one (71.4%, P ϭ 0.004). The overall complication rate was 4.2%. The mean hospital stay was 2.5 days (range 1 to 7 R enal colic is often caused by ureteral stones, with most of them located in the distal ureter. 1 When conservative drug therapy does not resolve the symptoms, the placement of a ureteral catheter or nephrostomy tube represents the classic procedure performed for renal colic due to acute ureteral obstruction. These maneuvers can offer a prompt relief from pain for the patient, and they are usually followed by ureteroscopy (URS) or extracorporeal shockwave lithotripsy (ESWL), which currently represents the mainstay of treatment for ureteral stones. 2 Although URS is a more invasive treatment option than ESWL, the success rate of the latter is probably lower, especially for mid and distal ureteral stones. 3,4 To date, ESWL, as a first-line therapeutic option, applied rapidly after the onset of renal colic, has been given very limited attention. Only two randomized trials have been reported, both with encouraging results, even if most cases were of proximal ureteral stones. 5,6 Emergency ESWL is an attractive proposition, because it can result in both stone disintegration and relief from acute obstruction.Recently, the miniaturization of ureteroscopes, together with the introduction of the holmium laser, has improved stone-free rates and decreased the complication rates, widening the indications for URS. 7 Similar to ESWL, emergency URS can result in both stone disintegration and relief from colic pain. However, significant data on the ureteroscopic management of ureteral stones in an emergency setting are completely lacking.We describe our experience in the emergency ureteroscopic management of ureteral stones. The outcome, complications, and supposed advantag...

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Section: Commentmentioning

confidence: 99%

Emergency Ureteroscopic Management of Ureteral Stones: Why Not?

Osório

Lima

Soares

et al. 2007

Urology

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“…Most patients with ureteric calculi can be managed using a variety of endoscopic techniques, including intracorporeal lithotripsy, pneumatic lithoclasty, and ureteroscopy with Dormier basket removal [1]. Open operative procedures for stone removal are now rarely necessary because of the success of endoscopic stone surgery [2,3]. However, despite the undoubted value of these techniques for treating urinary tract calculi there remain some fundamental obstacles which limit the success of some endoscopic procedures.…”

Section: Indicationsmentioning

confidence: 99%

A novel method to prevent retrograde displacement of ureteric calculi during intracorporeal lithotripsy

Ali

Halstead

et al. 2004

BJU International

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“…Vücut dışı şok dalga litotripsinin (ESWL) özellikle proksimal üreterden alt seviyelere gidildikçe daha başarısız olması bu taşların tedavisi için ÜRS'yi ilk seçenek haline getirmiştir. [4,5] ÜRS, erişkin ve adelosan dönemde çok daha kolay yapılabilen bir cerrahi prosedür iken özellikle okul öncesi yaş grubunda üreter çapının oldukça küçük ve üreter çeperinin nazik olması nedeniyle komplikasyonlara daha açık-tır. [6] Bu nedenle daha çok dikkat, deneyim ve endoürolojik uzmanlık gerektiren bir işlemdir.…”

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