Treatment of ureteral stones: comparison of extracorporeal shock wave lithotripsy and endourologic alternatives.

Kupeli B., Biri H., Isen K., ONARAN M., Alkibay T., Karaoglan U., ...Daha Fazla

European urology, cilt.34, sa.6, ss.474-9, 1998 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 34 Sayı: 6
  • Basım Tarihi: 1998
  • Doi Numarası: 10.1159/000019786
  • Dergi Adı: European urology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.474-9
  • Anahtar Kelimeler: ureteral stones, lithotripsy, extracorporeal shock wave lithotripsy, ureteroscopy, ELECTROHYDRAULIC LITHOTRIPSY, CALCULI, MANAGEMENT, URETEROSCOPY, EXPERIENCE
  • Gazi Üniversitesi Adresli: Evet

Özet

Aim of the Study: The aim of the study is to compare the effectiveness of ESWL and ureteroscopic lithotripsy with pneumatic, ultrasonic and electrohydraulic modalities in patients with ureteral stones. Patients and Method: In this study, 1970 patients with ureteral stones were evaluated, ESWL and ureteroscopic lithotripsies were performed in 1580 and 484 patients, respectively. The ESWL group was treated with a Siemens Lithostar plus. Ureteroscopic lithotripsy was performed with pneumatic lithotripsy (PL), ultrasonic lithotripsy (USL) and electrohydraulic lithotripsy (EHL) in 140 (28.9%), 311 (64.3%) and 33 (6.8%) patients, respectively. 94 patients underwent both because of unsuccessful ESWL therapy. Results: In the ESWL group, the stone-free rate was 49.9% and the fragmentation rate 71.0%. These values were: 95.0 and 97.1% for PL; 88.1 and 89.4% for USL; 90.9 and 93.9% for EHL, respectively. Ureteroscopic lithotripsy has been found more effective than ESWL in the treatment of middle and lower ureteral calculi (p < 0.001) and PL has the greatest success rate within these endoscopic groups. Conclusion: ESWL therapy can be the first-line therapy in upper ureteral stones keeping the other modalities for unfragmented stones. However, ureteroscopic lithotripsy is the most effective treatment choice in lower ureteral stones no matter which kind of energy used and PL is the most effective and less complicated among the other types.