Ureteral Stone Management: Emerging Concepts

Lingeman, James E.; Sonda, L. Paul; Kahnoski, Richard J.; Coury, Thomas A.; Newman, Daniel M.; Mosbaugh, Phillip G.; Mertz, Jack H. O.; Steele, Ronald E.; Frank, Barbara

doi:10.1016/s0022-5347(17)46027-7

Cited by 93 publications

(16 citation statements)

References 11 publications

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“…Discussion URS has proved to be a valuable tool in the manage ment of upper urinary tract calculus disease. Success rates of more than 80% in large series have been reported [1,6,7], However, these reports comprise very few calculi in the upper part of the ureter, and the proce dure has been applied mainly for calculi in the mid and distal ureter [2,4], Our overall success rate for ureteric stones is 71 %, and 89% in the lower third of ureter. This is equal to the results of others and confirms that URS is a very efficient procedure especially in the lower part of the ureter.…”

Section: Resultsmentioning

confidence: 99%

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Ureterorenoscopy in the Management of Renal and Ureteric Calculi

Olsen¹,

Pedersen²,

Wamberg³

et al. 1989

Urol Int

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A total of 172 ureterorenoscopies were performed in 112 patients with 131 ureteric and renal calculi. The success rates for retrieval were 65, 59 and 79% in the upper, middle and lower third of the ureter, respectively. 32% of renal calculi were removed by ureterorenoscopy. By combined endourological techniques 89% of all stones were removed. Few complications occurred, and no late sequelae were recorded. It is concluded that ureterorenoscopic stone retrieval is an efficient and safe procedure, especially for lower ureteric stones. In the hand of a trained endourologist it might be attempted for upper ureteric calculi as well, and for certain renal stones in selected patients.

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Section: Resultsmentioning

confidence: 99%

“…If ESWL is available, this should be the primary modality of therapy in suitable upper urinary tract calcu li, but it has been emphasized that mastering of endourology is essential for the optimal management of uri nary calculi [4,6].…”

Section: Resultsmentioning

confidence: 99%

Ureterorenoscopy in the Management of Renal and Ureteric Calculi

Olsen¹,

Pedersen²,

Wamberg³

et al. 1989

Urol Int

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“…Endoscopy was therefore proposed as primary treatment first for mid and lower ureteric stones, with a success rate greater than 90% [4, 5, 6, 7, 8, 9], and finally for upper ureteric stones. The review of our series of 378 cases of primary endoscopic treatment of ureteral stones, which is consistent enough for making statistically valuable considerations, seems to reinforce the actual positive trend toward endoscopy [10].…”

Section: Discussionmentioning

confidence: 99%

Primary Endoscopic Treatment of Ureteric Calculi

Puppó

Ricciotti

et al. 1999

European Urology

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“…However, pushing the stone back into the kidney is also an interventional procedure with its own risks, with a failure rate ranging from 28%-50%. 8,9 In our study, we had a 94% overall clearance rate for the upper ureteral stones without any intervention. In 19 patients (24%), a Double-J stent was inserted prior to treatment but it was only for those with severe hydronephrosis or a solitary kidney.…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal Shock Wave Lithotripsy in the Treatment of Ureteric Stones: Experience from Tawam Hospital, United Arab Emirates

Ghafoor

Halim

2002

Ann Saudi Med

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Background:The optimal treatment of ureteric stones, especially the lower ureteric stone, remains controversial. The purpose of this study was to evaluate the role of extracorporeal shock wave lithotripsy (ESWL) in the management of ureteric stones. Materials and Methods: A total of 99 patients with ureteric stones at different levels were treated with ESWL from 1994 through 1998 at our hospital. All patients were treated using Siemen Lithostar-II Plus Lithotripter. Of the 99 patients, 20 were excluded from the study because they had no follow-up records of their stone-free status. The clearance rates for ureteric stones of the other 79 patients treated were stratified according to the site, size, and number of treatment sessions required per stone. The stone size was determined by the widest diameters. Based on stone size, the patients were divided into two groups: A (≤10 mm) and B (11-20 mm). Results: The overall clearance rate for ureteric stones treated with ESWL, irrespective of its site and size, was 78.5%. The overall clearance rate for size A (≤10 mm) stones was 82% and size B (11-20 mm) was 58% regardless of the site of the stone in the ureter. A total of 17 upper ureteric stones were treated with ESWL. The overall clearance rate for upper ureteric stones was 94%. Thirteen patients with mid-ureteric stones were treated with ESWL. The overall clearance rate for the mid-ureteric stones was 92.3%. Forty-nine patients had lower ureteric stones. The overall clearance rate for the lower ureteric stones was 69.3%. Conclusions: ESWL is safe, effective, noninvasive and a convenient way of treatment for all ureteric stones. The clearance rate for stones in the upper and mid-ureter is above 90%. ESWL being an outpatient procedure without any need for anesthesia or any pretreatment intervention, it should be considered as the first line of treatment for all stones in the upper and mid-ureter. The clearance rate for small stones (≤10mm) in the lower third of the ureter was 73.8% in our study and for these, ESWL may be considered as a primary therapy. For stones larger than 10 mm in the distal third of ureter, the clearance rate was low with a high retreatment rate, and ureteroscopy as primary treatment modality would be more preferable. Ann Saudi Med 2002,-22(1-2) The current management of upper urinary tract calculi is based on stone fragmentation into smaller pieces which are allowed to pass spontaneously, or removed with an endoscope. To achieve this, energy should be transferred to the stone either percutaneously (extracorporeal shock wave lithotripsy) or through an endoscope (intracoporeal lithotripsy). Chaussy et al. in 1980 was the first to report the clinical application of shock wave lithotripsy in the management of kidney stones, and since then the management of nephrolithiasis has undergone a complete revolution.1 Recent technological developments have resulted in more advanced lithotripters with shorter focal length and more narrow focal breadth, which help reduce the level of pain and ultimately obviate...

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Ureteral Stone Management: Emerging Concepts

Cited by 93 publications

References 11 publications

Ureterorenoscopy in the Management of Renal and Ureteric Calculi

Ureterorenoscopy in the Management of Renal and Ureteric Calculi

Primary Endoscopic Treatment of Ureteric Calculi

Extracorporeal Shock Wave Lithotripsy in the Treatment of Ureteric Stones: Experience from Tawam Hospital, United Arab Emirates

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