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Results for “URETERAL CALCULI”

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At least 19 recordsLinked to original sources
PubMed1988

Comparison of transurethral ureteroscopy and extracorporeal shock wave lithotripsy for treatment of ureteral calculi.

Ureteral calculi were treated by transurethral uretereoscopy and extracorporeal shock wave lithotripsy (ESWL), and the results were compared. Rigid transurethral ureteroscopy was performed in 50 patients, and 10 of 22 stones located in the upper ureter and 25 of 29 stones located in the lower ureter were successfully extracted. On the other hand, we treated 88 patients with upper ureteral stones by ESWL and achieved a success rate of 89.8%. We therefore conclude that for upper ureteral stones, ESWL is the more effective treatment and, for lower ureteral stones, transurethral ureteroscopy.

Adult↗
PubMed2006

[Ureteroscopy (URS) for ureteric calculi].

Distal ureteral calculi (<5 mm) usually pass the ureter spontaneously. Ureteroscopic lithotripsy of distal ureteral calculi shows high stone-free rates with a low complication rate (4%) and is equal to extracorporeal shock wave lithotripsy (ESWL), while ESWL is the primary choice for proximal ureteric stones. Flexible endoscopes are more difficult to handle and should be used only under fluoroscopic control. They are generally used in combination with the holmium:YAG laser and the flexible Lithoclast in the proximal ureter or the renal collecting system. Overall the complication rate of URS is 9-11% with avulsion of the ureteric urothelium being the most common complication. Ureteral perforation, stricture (<1%), impaction of the instrument in the ureter with consequent ureteral laceration, extravasation of stones, and bleeding in the urogenital tract are complications of URS but are minimal in the hands of a well-trained and skilled surgeon.

Humans↗
PubMed1995

Indwelling ureteral stents as definitive therapy for distal ureteral calculi.

Distal ureteral calculi are a common urological problem often requiring surgical and anesthetic intervention. In a health care system with limited resources this intervention can lead to the expenditure of significant monies. Ureteral stents are often used to stabilize symptomatic patients preoperatively. Since stent placement causes passive ureteral dilation, we hypothesized that temporary placement of a ureteral catheter would facilitate spontaneous calculus passage. We prospectively studied 27 patients who presented with distal ureteral calculi less than 10 mm. large and met criteria established for surgical intervention. Self-retaining Double-J stents were placed in 10 male and 7 female patients, and left for 2 weeks using only topical anesthesia during the procedures. In the majority of the patients (83%) the calculi passed spontaneously after stent removal, obviating surgical or anesthetic intervention.

Female↗
PubMed1979

Giant ureteral calculi.

Giant ureteral calculi are defined as weighing at least 50 g or measuring more than 5 cm in greatest diameter. Two patients with this rare entity are described.

Female↗
PubMed1978

Comparison of radiological measurement and actual size of ureteral calculi.

100 ureteral calculi were measured on X-ray films and directly on the stone after passage or removal. The largest diameters were compared. The size of the stone was radiologically overestimated for 59 stones, correct for 26 and underestimated for 15. 73 of the stones were radiologically measured within +/-25% of the actual size.

Evaluation Studies as Topic↗
PubMed1986

Extracorporeal shockwave lithotripsy of distal ureteral calculi.

To date, the use of extracorporeal shockwave lithotripsy (ESWL) has been limited to renal calculi and ureteral calculi above the pelvic brim. Modifying the position of the patient on the support of the Dornier lithotripter HM3, we were able to localize and treat distal ureteral calculi. Until April 1986, 43 patients with stones in the lower ureter underwent contact-free lithotripsy. Treatment was successful in 39 patients (90%), 2 of these requiring 2 sessions. In 4 patients treatment failed and stone removal was accomplished using ureteroscopy or open surgery. No complications or adverse side effects were encountered in the whole series. ESWL is now the method of choice for the treatment of distal ureteral calculi in our department.

Adult↗
PubMed1988

A modified algorithm for the management of ureteral calculi: 100 consecutive cases.

We treated 100 consecutive ureteral calculi requiring intervention with a previously described algorithm. There were 16 ureteropelvic junction, and 18 upper, 22 mid and 44 lower ureteral calculi. Treatment was by a stent and extracorporeal shock wave lithotripsy in 10 ureteropelvic junction, 10 upper ureteral and 3 mid ureteral calculi, ureteroscopy and extracorporeal shock wave lithotripsy in 6 upper and 6 mid ureteral calculi, and ureteroscopy alone in 5 ureteropelvic junction, 2 upper and 12 mid ureteral calculi. All 44 lower ureteral calculi were treated successfully by ureteroscopy. Of the 100 patients studied 98 were treated by endourological methods (extracorporeal shock wave lithotripsy or ureteroscopy), while 2 required an operation (1 with a ureteropelvic junction calculus and 1 with a mid ureteral calculus). Over-all, 100 patients required a total of 125 procedures to accomplish successful stone removal. An algorithm is developed in which lower ureteral calculi are treated by ureteroscopy, mid ureteral calculi (large and dense) by stent bypass and extracorporeal shock wave lithotripsy or (lucent and fragile) by ureteroscopy, upper ureteral calculi by stent bypass and extracorporeal shock wave lithotripsy without manipulation, and impacted ureteral stones initially by ureteroscopy and, if necessary, then by extracorporeal shock wave lithotripsy.

Algorithms↗
PubMed1993

In situ ESWL for ureteric calculi: the optimum treatment?

In situ ESWL for ureteric calculi is associated with good stone clearance rates but is it without significant morbidity? A review of 189 patients with single ureteric calculi (150 upper ureter, 39 lower ureter calculi) revealed an 89% stone clearance for upper ureteral calculi and 80% stone clearance for lower ureteral calculi. However 11% of patients with upper ureteral calculi and 20% of patients with lower ureteral calculi required additional intervention for complications or failed treatment. In situ ESWL may not be the optimum therapy for all ureteric calculi especially those in the lower ureter.

Adolescent↗
PubMed1995

The case for primary endoscopic management of upper urinary tract calculi: II. Cost and outcome assessment of 112 primary ureteral calculi.

OBJECTIVES: To compare extracorporeal shock-wave lithotripsy (ESWL) with endoscopic lithotripsy to establish the more efficacious and cost-effective treatment for ureteral calculi. METHODS: The records of 112 patients with primary ureteral calculi treated at one center with either ESWL or endoscopic lithotripsy were retrospectively reviewed. Follow-up data at 1 and 3 months were obtained in all patients. Success was defined as complete clearance of a stone burden in the endoscopy group. In the ESWL group patients with a residual, asymptomatic 2-mm fragment were also considered successful treatments. The number of auxiliary procedures, retreatments, postoperative office visits, and imaging studies required before a patient was considered stone free was defined. The impact of these variables on global costs was carefully reviewed. RESULTS: Patients with ureteral calculi primarily treated with ESWL or ureteroscopic lithotripsy had stone-free rates after a single session of 45% versus 95% at 1-month follow-up, and 62% versus 97% at 3-month follow-up. Retreatment and auxiliary procedure rates were significantly higher in the ESWL group (31% versus 3%). The mean number of postoperative visits and imaging studies until a patient was stone free was also higher in the ESWL group (2.07 versus 1.13). Operative treatment costs were similar for both modalities, but overall costs weighed heavily against ESWL. CONCLUSIONS: ESWL remains the treatment of choice for moderately sized, uncomplicated renal calculi. In skilled hands, ureteroscopic lithotripsy is by far the most expeditious and cost-effective means of clearing a ureteral stone burden.

Costs and Cost Analysis↗
PubMed1992

Management of ureteric calculi (minimally invasive therapy of ureteric stones).

As documented with results obtained in 1685 patients the treatment of ureteric stones is today based on ESWL in situ and ureteroscopy with semirigid, ultrathin ureteroscopes and laser lithotripsy. All stones in the upper third of the ureter and larger stones in the distal third of the ureter are preferably treated with ESWL in situ whereas smaller stones in the distal ureter are better treated endoscopically. Midureteric stones remain the domain of primary ureteroscopy; with moderate obstruction in the asymptomatic patient it may also be acceptable to wait for the stone to pass into the distal ureter spontaneously to be treated by ESWL in situ there. Manipulating stones back into the kidney and treating them by ESWL there (pushback/ESWL) offers no advantage over ESWL in situ, as the results are similar, yet morbidity is higher. Blind instrumentation and open surgery have lost all justification.

Endoscopy↗