Abstract:
:Based on experience with over 2,000 patients, the treatment of ureteric stones today relies on extracorporeal shock wave lithotripsy (ESWL) in situ and ureteroscopy with semirigid, ultrathin ureteroscopes combined with pneumatic or laser lithotripsy. All stones in the upper and larger stones in the distal third of the ureter are preferably treated by ESWL in situ, whereas smaller stones in the distal ureter are better treated by endoscopy. Midureteric stones continue to be the domain of primary ureteroscopy; in cases of moderate obstruction in asymptomatic patients, 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. Manipulation of the stone back into the kidney and treating it by ESWL there (push back/ESWL) offers no advantage over ESWL in situ, as results are not better yet morbidity is higher. 'Blind' instrumentation has lost all justification, and incisional ureteric lithotomy is no longer indicated but in exceptional cases.
journal_name
Eur Uroljournal_title
European urologyauthors
Marberger M,Hofbauer J,Türk C,Höbarth K,Albrecht Wdoi
10.1159/000475300subject
Has Abstractpub_date
1994-01-01 00:00:00pages
265-72issue
4eissn
0302-2838issn
1873-7560pii
S0302-2838(03)00579-7journal_volume
25pub_type
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