Management of ureteric stones.

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 Urol

journal_title

European urology

authors

Marberger M,Hofbauer J,Türk C,Höbarth K,Albrecht W

doi

10.1159/000475300

subject

Has Abstract

pub_date

1994-01-01 00:00:00

pages

265-72

issue

4

eissn

0302-2838

issn

1873-7560

pii

S0302-2838(03)00579-7

journal_volume

25

pub_type

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