The CO2 flush: a new technique for percutaneous extraction of ureteral calculi.

Young, A. T.; Hunter, Donald; Lange, Paul H.; Lund, Gunnar B.; Castańeda-Zúńiga, W R; Hulbert, J C; Mercado, S; Cardella, J F; Amplatz, K

doi:10.1148/radiology.154.3.3918334

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Radiology

1985

DOI: 10.1148/radiology.154.3.3918334

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The CO2 flush: a new technique for percutaneous extraction of ureteral calculi.

A. T. Young¹,

Donald Hunter²,

Paul H. Lange³

et al.

Abstract: A new technique for the percutaneous extraction of ureteral calculi is described. A jet of CO2 is injected through a retrograde ureteral catheter to dislodge ureteral stones. This safe and simple technique has been successfully used in ten patients.

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1985

1988

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Ureteral Stone Manipulation Before Extracorporeal Shock Wave Lithotripsy

et al. 1988

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We randomized 75 patients with solitary ureteral calculi that could not be dislodged by ureteral catheterization to receive instillation of saline, 2 per cent lidocaine viscous solution or dilute surgical lubricant before repeat stone manipulation with ureteral catheters. Of the stones irrigated with saline 76 per cent were returned to the pelvis along with 60 per cent of the lidocaine group and 48 per cent of the surgical lubricant treated stones. There was no statistical significance among the 3 groups. The success rates for upper, mid and lower ureteral stones were 80, 54 and 30 per cent, respectively. Of stones 0.5 cm. or less and between 0.6 and 1.0 cm. 77 and 72 per cent, respectively, were manipulated successfully but only 38 per cent of the stones larger than 1.0 cm. could be dislodged. Extracorporeal shock wave lithotripsy was successful in treating pelvic and ureteral stones, although higher kilovolt settings and additional shocks were necessary to fragment the ureteral stones completely. Percutaneous nephrostomy or ureteral meatotomy was required in 10 per cent of the patients with impacted ureteral stones following in situ extracorporeal shock wave lithotripsy but in only 4 per cent of the patients with stones successfully returned to the pelvis. Of the ureteral stones 17 per cent were treated with repeat extracorporeal shock wave lithotripsy. No patient with pelvic stones required repeat treatment. Retrograde manipulation of ureteral stones is an effective adjunctive procedure before extracorporeal shock wave lithotripsy.

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Ureteral Stone Manipulation Before Extracorporeal Shock Wave Lithotripsy

et al. 1988

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Percutaneous Management of Ureteral Calculi Facilitated by Retrograde Flushing with Carbon Dioxide or Diluted Radiopaque Dye

et al. 1985

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Of 356 patients in whom percutaneous nephrostomy was performed at this institution 59 had ureteral stones. In our experience with the first 36 patients antegrade techniques for ureteral stone extraction had many assets but sometimes they were difficult. Recently, we incorporated a retrograde flushing technique, using carbon dioxide and diluted radiopaque dye, into our percutaneous approach to ureteral stones. Based on our experience with this technique in the next 23 consecutive patients, we believe that percutaneous nephrostolithotomy and retrograde flushing should be added to the armamentarium of urologists committed to the percutaneous endourological approach to ureteral stones.

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The CO2 flush: a new technique for percutaneous extraction of ureteral calculi.

Abstract: A new technique for the percutaneous extraction of ureteral calculi is described. A jet of CO2 is injected through a retrograde ureteral catheter to dislodge ureteral stones. This safe and simple technique has been successfully used in ten patients.

Cited by 2 publications

References 0 publications

Ureteral Stone Manipulation Before Extracorporeal Shock Wave Lithotripsy

Ureteral Stone Manipulation Before Extracorporeal Shock Wave Lithotripsy

Percutaneous Management of Ureteral Calculi Facilitated by Retrograde Flushing with Carbon Dioxide or Diluted Radiopaque Dye

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