Efficacy of Semirigid Ureteroscopy with Pneumatic Lithotripsy for Ureteral Stone Surface Area of Greater Than 30 mm2
- 1 April 2009
- journal article
- clinical trial
- Published by Mary Ann Liebert Inc in Journal of Endourology
- Vol. 23 (4), 619-622
- https://doi.org/10.1089/end.2008.0182
Abstract
Objectives: To study the outcome and safety of semirigid ureteroscopy (URS) using pneumatic lithotripsy for treatment of ureteral stones of surface area >30 mm2 and to assess the impact of size and location on stone-free (SF) rate. Patients and Methods: In this study, 265 patients with >30 mm2 isolated ureteral stones treated by semirigid URS were included. URS was performed using an 8F, 7F, or 6.4F semirigid ureteroscopes with pneumatic lithotripsy (Swiss Lithoclast™). Stones were fragmented to ∼2–3 mm particles, and removed. The outcome parameters assessed at 3-month follow-up were SF rate and efficiency quotient (EQ); impact of stone size and site on SF/EQ was also analyzed. The patient demographics, stone, procedure, and patient-related parameters and complications were noted. Results: At 3-month follow-up overall SF was 74% and EQ 59.2%. SF for 30–100 mm2 and >100 mm2 was 79.2% and 68.5%, respectively (p < 0.003). The SF/EQ for upper, middle, and lower ureteral stones were 59/40.7, 53/37.5, and 92/84.5, respectively (p < 0.001). There was no major complication; the minor complication rate was 12.5%. Conclusions: Semirigid URS using pneumatic lithotripsy for treatment of stones >30 mm2 is a safe and highly efficacious procedure particularly in the distal ureter. There is a significant difference in the SF and EQ between upper/middle ureteral stone and lower ureteral stone. Stone size has a direct relation with the SF and EQ. Upper ureteral stones have a longer time to SF compared to middle and lower ureteral stones (p < 0.001).Keywords
This publication has 21 references indexed in Scilit:
- How Efficient Is Extracorporeal Shockwave Lithotripsy with Modern Lithotripters for Removal of Ureteral Stones?Journal of Endourology, 2008
- Management of 10–15-mm Proximal Ureteral Stones: Ureteroscopy or Extracorporeal Shockwave Lithotripsy?Urology, 2008
- The Silence of the Stones: Asymptomatic Ureteral CalculiJournal of Urology, 2007
- 2007 Guideline for the Management of Ureteral CalculiEuropean Urology, 2007
- Pneumatic lithotripsy for large ureteral stones: is it the first line treatment?International Urology and Nephrology, 2007
- Appropriate cutoff for treatment of distal ureteral stones by single session in situ extracorporeal shock wave lithotripsyUrology, 2005
- A 10‐year experience of managing ureteric calculi: changing trends towards endourological intervention—is there a role for open surgery?BJU International, 2001
- Therapeutic Efficacy of Dornier MPL 9000 for Prevesical Calculi as Judged By Efficiency QuotientJournal of Endourology, 2000
- URETERAL STONES CLINICAL GUIDELINES PANEL SUMMARY REPORT ON THE MANAGEMENT OF URETERAL CALCULIJournal of Urology, 1997
- Lithostar: An Electromagnetic Acoustic Shock Wave Unit for Extracorporeal LithotripsyJournal of Endourology, 1989