Primary in situ extracorporeal shock wave lithotripsy in the management of ureteric calculi: results with a third‐generation lithotripter

Abstract

Objective To review the results of primary in situ cations. Stone-free rates were 90% for upper ureteric, 89% for middle-third and 86% for lower-third calculi. extracorporeal shock wave lithotripsy (ESWL) for the treatment of ureteric stones using a third-generation Twenty-one patients required auxiliary procedures in the form of JJ stenting or nephrostomy. Failure of lithotripter, the Dornier MFL 5000 (Dornier Medizentechnic, Germany).ESWL was associated with stone size (>1.3 cm) but not location or inadequate treatment. Patients and methods The study comprised a retrospective review of treatment outcome in 180 patients with Conclusion Where prompt access to ESWL is available, primary in situ ESWL remains an eCective form of 196 stones who were treated with primary in situ ESWL, assessing the success of this approach and treatment for all ureteric calculi, although stone-free rates are lower for larger stones. establishing reasons for failure. Results At the 3-month follow-up, 88% of patients were Keywords Extracorporeal shock wave lithotripsy, Dornier MFL 5000, ureteric calculi stone-free; 21 patients failed ESWL and were treated by ureteroscopic stone extraction with no compliwhether results were comparable with those published

In Situ Extracorporeal Shock-Wave Lithotripsy as a Primary Treatment for Ureteral Stones

“…In addition, other studies correlated treatment failure with ESWL voltage and stone composition, but not location or inadequate treatment. 3,8,9 A subgroup of calculi less likely to succeed could thus be identified: calculi >1 cm 2 , with severe uropathy and functional annulment or delay. The major disadvantages of ESWL are the number of repetitions often required, and the long wait until the last fragment is passed.…”

“…It is highest in the distal ureter, with lesser success in the middle and proximal ureter in that order. 8,10 Although URS with holmium laser lithotripsy achieves excellent results for proximal ureteral stones 1 cm or larger, ESWL is equally efficient for stones less than 1 cm. 11 The consensus is that ESWL therapy should remain a first-line choice in upper ureteral stones, especially if it is less than 1 cm, keeping other modalities for unfragmented stones.…”

“…Such studies support proponents of ESWL as a first choice treatment of ureteral calculi regardless the location, while saving URS as a first choice for distal obstructive calculi and those with difficult radiological study. 3,5,8,16 Although stones in the upper ureter might respond better to ESWL treatment than those in the lower ureter, the ultimate treatment results are comparable in both clinical settings. At an institution where ESWL and URS are equally available, ESWL is still a valid safe and simple non-invasive option of choice for most ureteral calculi at different levels.…”

Proksimal üreter taşı olan 96 olguda ESWL tedavisi sonuçları

“…Birçok çalışmada %80-%90 başarı oranı rapor edilmiş ve üreter taşlarının tedavisinde ilk tedavi seçeneği olabileceği vurgulanmıştır (2)(3)(4). Bu çalışmada, kliniğimizde Ocak 2013-Ocak 2014 tarihleri arasında proksimal üreter taşı olup ESWL tedavisi uygulanan 96 olguda sonuçlarımız geriye dönük olarak incelenmiş ve literatür eşliğinde tartışılmıştır.…”

Mid ureteric stone clearance by Extracorporeal Shock Wave Lithotripsy (ESWL): a clinical study

“…It become a safe and accepted method of treatment for urinary tract stones and in 1984 was approved by FDA [19][20][21] . It has been recommended as a first-line treatment for mid ureteric calculi in several studies and reported 80-90% success rate 1,19,[23][24][25] . It is a standardized procedure which results in stone free rates depend on the size, composition and the location of the stone as well as the type of the lithotripter 1,26,27 .…”