What is the optimal treatment for lower ureteral stones larger than 1 cm?
International journal of urology : official journal of the Japanese Urological Association, cilt.7, sa.5, ss.167-71, 2000 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 7 Sayı: 5
- Basım Tarihi: 2000
- Doi Numarası: 10.1046/j.1442-2042.2000.00162.x
- Dergi Adı: International journal of urology : official journal of the Japanese Urological Association
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.167-71
- Anahtar Kelimeler: Extracorporeal shock wave lithotripsy, Lower ureteral stones, Pneumatic lithotripsy, Ureterolithotomy
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Gazi Üniversitesi Adresli: Evet
Özet
Purpose: To compare the treatment options for lower ureteral stones larger than 1 cm. Methods: The records of 449 patients with lower ureteral calculi larger than 1 cm were reviewed retrospectively. Of these patients 342 (76.1%) were treated with extracorporeal shock wave lithotripsy (ESWL) (group 1), 66 (14.7%) with pneumatic lithotripsy (PL) (group 2) and 128 (28.5%) with ureterolithotomy (group 3). Eighty-seven (19.5%) patients underwent any of the two treatment modalities because of unsuccessful primary treatment. Results: The overall stone-free rates were 32.4, 90.9 and 95.3% for ESWL, PL and ureterolithotomy, respectively. These values were 84.4% for primary PL and 96.7% for primary ureterolithomy. The re-treatment rate (46.4%) and secondary procedures were much more frequent in the ESWL group. There was no difference in the complication rates of the three groups. Conclusions: Pneumatic lithotripsy with ureteroscopy seems to be an appropriate treatment for larger ureteral stones. While ESWL can be tried as a first treatment option because of its non-invasive nature, lower success and higher re-treatment rates limit its usefulness. Ureterolithotomy is still a reasonable alternative for these large or unfragmented stones.