Primary Ureteroscopy for Distal-Ureteral Stones Compared with Ureteroscopy after Failed Extracorporeal Lithotripsy

Tuğcu, Volkan; Gürbüz, Gökhan; Aras, Bekir; Gurkan, Levent; Ötünçtemur, Alper; Taşçı, Ali İhsan

doi:10.1089/end.2006.20.1025

Cited by 16 publications

(29 citation statements)

References 20 publications

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“…Moreover, we reported a stone-free rate for calculi in the distal ureter after one and two treatments with URSL of 77.5% and 100%, respectively. This confirms previous reports about safety and efficacy of URSL with YAG laser treatment in treating proximal and distal ureteral stones (9,11). Usually, post-operative placement of a ureteral DJ stent after URSL is still a subject of debate.…”

Section: Discussionsupporting

confidence: 89%

See 1 more Smart Citation

Ten-year experience in the management of distal ureteral stones greater than 10 mm in size

Dell’Atti¹

2016

Gchir

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Section: Discussionsupporting

confidence: 89%

“…However, the optimal first-line strategy is still a controversial issue (8). Many studies have been published comparing the two methods with various results (9)(10)(11). Stone size and location have had an impact on the success of treatment.…”

Section: Discussionmentioning

confidence: 99%

Ten-year experience in the management of distal ureteral stones greater than 10 mm in size

Dell’Atti¹

2016

Gchir

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“…[15][16][17][18][19] ESWL başarısızlığında pnömotik litotoriptör kullanılarak uygulanan üreteroskopik litotripsinin %95.6'lık başarı oranına sahip olduğu ve bu grup hastalarda operasyon süresinin ESWL öyküsü olmayanlardan anlamlı olarak daha uzun olduğu yakın zamanlı çalışmalarla gösterilmiştir. [20] ESWL başarısızlığı sonrası böbrek taşlarında retrograd intrarenal cerrahi uygulamasının yüksek başarı ve ESWL'den daha iyi taşsızlık oranlarına sahip olduğu da bilinmektedir. [21,22] Çalışmamızda ESWL sonrası ÜRS yapılan hastalarda başarı oranı ESWL öyküsü olmayanlardan anlamlı derecede düşük bulundu.…”

Section: Discussionunclassified

The need for additional equipment after ESWL in ureteroscopic lithotripsy

Guner¹,

Çaşkurlu²,

Karakose³

et al. 2011

Turkish Journal of Urology

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Objective: This study evaluated our results with ureteroscopic lithotripsy (URS) in patients with failed extracorporeal shock wave lithotripsy therapy (ESWL) and examined the effect of previous ESWL on the use of tools during URS, operating time, and outcome. Materials and methods:URS performed in two centers between 2008 and 2011 was reviewed retrospectively. The patients were divided into two groups according to the history of previous ESWL: 1) patients who underwent ESWL previously (n=39) and 2) no previous ESWL (n=116). Results:The demographic data were similar in both groups. The use of accessory tools and treatment failure was statistically higher in Group 1. The operating time was longer in Group 1. The need for re-operation, balloon dilatation, and ureteral catheter was similar in the two groups. However, the use of accessory equipment was increased by 56% in those with a previous ESWL. Balloon dilatation was required in 17.9% of the patients in Group 1. Conclusion:URS is the main treatment modality after the failure of ESWL. In patients with a history of ESWL, the need for accessory equipment is increased.Key words: Equipment; lithotripsy; treatment failure; ureteroscopy. ÖZETAmaç: Çalışmanın amacı vücut dışı şok dalga tedavisi (ESWL) başarısız olmuş hastalarda üreteroskopik litotripsi (ÜRS) sonuçlarımızı incelemek ve geçirilmiş ESWL öyküsünün ÜRS esnasında alet kullanımı, operasyon süresi ve başarı üzerine olan etkisini değerlendirmektir. Gereç ve yöntem:2008-2011 yılları arasında iki merkezde yapılan ÜRS vakaları retrospektif olarak değer-lendirildi ve geçirilmiş ESWL öyküsüne göre hastalar iki gruba ayrıldı. ESWL öyküsü olan 39 hasta Grup 1, ESWL öyküsü olmayan 116 hasta Grup 2 olarak tanımlandı. Bulgular:Her iki grubun demografik verileri benzerdi. Grup 1'de başarısızlık ve aksesuar alet kullanımı istatistiksel olarak daha yüksekti. Operasyon süresi Grup 1'de daha uzun olarak tespit edildi. Geçirilmiş ESWL öyküsü olanlarda yeniden operasyon, balon dilatasyon gereksinimi ve üreter kateteri gereksinimi ESWL öyküsü olmayan hastalarla benzerdi. Ancak geçirilmiş ESWL öyküsü olanlarda aksesuar alet kullanımı %56 oranında artmakta idi. Stone cone, en sık kullanılan aksesuar alet idi. Grup 1'deki hastaların %17.9'unda balon dilatasyon gereksinimi oldu.Sonuç: ESWL başarısızlığı sonrası ÜRS esas tedavi yöntemidir. Geçirilmiş ESWL öyküsü olanlarda aksesuar alet kullanım gereksinimi artmaktadır. Son üç dekatda üreteroskopi (ÜRS) ve dışa-rıdan şok dalga tedavisi (ESWL) cihazlarının gelişimiyle üreter ve böbrek taşı tedavisinde yeni bir çığır açılmıştır. Avrupa ve Amerika rehberlerinde yer alan bir tedavi seçeneği olarak ESWL, son yıllarda düşük morbidite ve yüksek başarı oranları ile üriner sistem taşları-nın tedavisinde yaygın olarak kullanılmaktadır.ESWL için kullanılan cihazlardaki teknolojik gelişime rağmen, halen hem taşların tamamı bu yöntemle kırılmadığı için hem de sistemin taşlardan tamamen temizlenebilmesi için ek cihaz ve girişimlere ihtiyaç duyulabilmektedır. Daha küçük çaplı ve daha geniş ça...

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“…Stone size was defined as the largest diameter measured on abdominal computed tomography (CT) scans. The distal ureter was defined as the segment between the lower border of the sacroiliac joint and the ureterovesical junction in accordance with previous studies [2,11]. …”

Section: Methodsmentioning

confidence: 99%

Influence of Ureteral Stone Components on the Outcomes of Electrohydraulic Lithotripsy

et al. 2012

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PurposeWe evaluated the influence of urinary stone components on the outcomes of ureteroscopic removal of stones (URS) by electrohydraulic lithotripsy (EHL) in patients with distal ureteral stones.Materials and MethodsPatients with a single distal ureteral stone with a stone size of 0.5 to 2.0 cm that was completely removed by use of EHL were included in the study. Operating time was defined as the time interval between ureteroscope insertion and complete removal of ureteral stones. Ureteral stones were classified into 5 categories on the basis of their main component (that accounting for 50% or more of the stone content) as follows: calcium oxalate monohydrate (COM), calcium oxalate dihydrate, carbonate apatite (CAP), uric acid (UA), and struvite (ST).ResultsA total of 193 patients (131 males and 62 females) underwent EHL. The mean operating time was 25.1±8.2 minutes and the mean stone size was 1.15±0.44 cm. Calcium oxalate stones accounted for 64.8% of all ureteral stones, followed by UA (19.7%), CAP (8.3%), and ST (7.2%) stones. The mean operating time was significantly longer in the UA group (28.6±8.3 minutes) than in the COM group (24.0±7.8 minutes, p=0.04). In multivariate analyses, the stone size was negatively associated with the odds ratio (OR) for successful fragmentation. UA as a main component (OR, 0.42; 95% confidence interval, 0.20 to 0.89; p=0.023) was also found to be significantly important as a negative predictive factor of successful fragmentation after adjustment for stone size.ConclusionsThe results of the present study suggest that successful fragmentation by URS with EHL could be associated with the proportion of the UA component.

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Primary Ureteroscopy for Distal-Ureteral Stones Compared with Ureteroscopy after Failed Extracorporeal Lithotripsy

Abstract: When SWL fails, URS-PL is as safe and effective as primary URS. Pneumatic lithotripsy also seems to be effective for impacted stones.

Cited by 16 publications

References 20 publications

Ten-year experience in the management of distal ureteral stones greater than 10 mm in size

Ten-year experience in the management of distal ureteral stones greater than 10 mm in size

The need for additional equipment after ESWL in ureteroscopic lithotripsy

Influence of Ureteral Stone Components on the Outcomes of Electrohydraulic Lithotripsy

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