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Optimal Therapy for the Distal Ureteral Stone: Extracorporeal Shock Wave Lithotripsy Versus Ureteroscopy

1994; Lippincott Williams & Wilkins; Volume: 152; Issue: 1 Linguagem: Inglês

10.1016/s0022-5347(17)32816-1

1527-3792

Kevin R. Anderson, David W. Keetch, David Albala, Paramjit S. Chandhoke, Bruce L. McClennan, Ralph V. Clayman,

Traumatic Ocular and Foreign Body Injuries

No AccessJournal of Urology1 Jul 1994Optimal Therapy for the Distal Ureteral Stone: Extracorporeal Shock Wave Lithotripsy Versus Ureteroscopy Kevin R. Anderson, David W. Keetch, David M. Albala, Paramjit S. Chandhoke, Bruce L. Mcclennan, and Ralph V. Clayman Kevin R. AndersonKevin R. Anderson , David W. KeetchDavid W. Keetch , David M. AlbalaDavid M. Albala , Paramjit S. ChandhokeParamjit S. Chandhoke , Bruce L. McclennanBruce L. Mcclennan , and Ralph V. ClaymanRalph V. Clayman View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)32816-1AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Extracorporeal shock wave lithotripsy (ESWL‡ Dornier Medical Systems, Inc., Marietta, Georgia. ) is the optimal therapy for renal calculi less than 2cm. in diameter and for proximal ureteral calculi. Controversy continues over the initial approach to distal ureteral calculi (that is below the bony pelvis): in situ ESWL versus ureteroscopy. Since February 1990, 76 distal ureteral calculi were treated at our institution using either in situ ESWL (Dornier HM3 ESWL with a Stryker frame modification in 27 patients or Siemen’s Lithostar electromagnetic ESWL in 22) or ureteroscopy (27 patients). Patient age and stone size were similar among the groups. All ESWL treatments were performed with the patient under intravenous sedation and on an outpatient basis. Stone-free rates were 96% for the HM3 device, 84% for the Lithostar and 100% for ureteroscopy. Retreatment was required in 3 Lithostar cases (14%) and 1 HM3 case (4%). When compared to ESWL ureteroscopy for distal ureteral stones was more time-consuming, entailed routine placement of a ureteral stent, often required general anesthesia, more often led to hospitalization and doubled the convalescence period. From a cost standpoint, ESWL on an HM3 unit was a few hundred dollars more expensive than ureteroscopy. In summary, we believe that in situ ESWL provides optimal first line therapy for distal ureteral calculi, while ureteroscopy is better reserved as a salvage procedure should ESWL fail. © 1994 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByNguyen D, Hnilicka S, Kiss B, Seiler R, Thalmann G and Roth B (2018) Optimization of Extracorporeal Shock Wave Lithotripsy Delivery Rates Achieves Excellent Outcomes for Ureteral Stones: Results of a Prospective Randomized TrialJournal of Urology, VOL. 194, NO. 2, (418-423), Online publication date: 1-Aug-2015.Halachmi S, Nagar M, Golan S, Ginesin Y and Meretyk S (2018) Extracorporeal Shock Wave Lithotripsy for Large Ureteral Stones Using HM3 LithotriptorJournal of Urology, VOL. 176, NO. 4, (1449-1452), Online publication date: 1-Oct-2006.HOCHREITER W, DANUSER H, PERRIG M and STUDER U (2018) Extracorporeal Shock Wave Lithotripsy for Distal Ureteral Calculi: What a Powerful Machine can AchieveJournal of Urology, VOL. 169, NO. 3, (878-880), Online publication date: 1-Mar-2003.Clayman R (2018) UROLITHIASIS, ENDOUROLOGY AND LAPAROSCOPYJournal of Urology, VOL. 167, NO. 2 Part 1, (794-802), Online publication date: 1-Feb-2002.LAM J, GREENE T and GUPTA M (2018) Treatment of Proximal Ureteral Calculi: Holmium:Yag Laser Ureterolithotripsy Versus Extracorporeal Shock Wave LithotripsyJournal of Urology, VOL. 167, NO. 5, (1972-1976), Online publication date: 1-May-2002.Lotan Y, Gettman M, Roehrborn C, Cadeddu J and Pearle M (2018) Management Of Ureteral Calculi: A Cost Comparison And Decision Making AnalysisJournal of Urology, VOL. 167, NO. 4, (1621-1629), Online publication date: 1-Apr-2002.PEARLE M, NADLER R, BERCOWSKY E, CHEN C, DUNN M, FIGENSHAU R, HOENIG D, McDOUGALL E, MUTZ J, NAKADA S, SHALHAV A, SUNDARAM C, WOLF J and CLAYMAN R (2018) PROSPECTIVE RANDOMIZED TRIAL COMPARING SHOCK WAVE LITHOTRIPSY AND URETEROSCOPY FOR MANAGEMENT OF DISTAL URETERAL CALCULIJournal of Urology, VOL. 166, NO. 4, (1255-1260), Online publication date: 1-Oct-2001.PACE K, WEIR M, TARIQ N and HONEY R (2018) LOW SUCCESS RATE OF REPEAT SHOCK WAVE LITHOTRIPSY FOR URETERAL STONES AFTER FAILED INITIAL TREATMENTJournal of Urology, VOL. 164, NO. 6, (1905-1907), Online publication date: 1-Dec-2000.TEICHMAN J, PORTIS A, CECCONI P, BUB W, ENDICOTT R, DENES B, PEARLE M and CLAYMAN R (2018) IN VITRO COMPARISON OF SHOCK WAVE LITHOTRIPSY MACHINESJournal of Urology, VOL. 164, NO. 4, (1259-1264), Online publication date: 1-Oct-2000.HOLLOWELL C, PATEL R, BALES G and GERBER G (2018) INTERNET AND POSTAL SURVEY OF ENDOUROLOGIC PRACTICE PATTERNS AMONG AMERICAN UROLOGISTSJournal of Urology, VOL. 163, NO. 6, (1779-1782), Online publication date: 1-Jun-2000.TURK T and JENKINS A (2018) A COMPARISON OF URETEROSCOPY TO IN SITU EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY FOR THE TREATMENT OF DISTAL URETERAL CALCULIJournal of Urology, VOL. 161, NO. 1, (45-47), Online publication date: 1-Jan-1999.Wolf J, Bub W, Endicott R and Clayman R (2018) Use of Intravenous Contrast Material During in Situ Extracorporeal Shock Wave Lithotripsy of Ureteral CalculiJournal of Urology, VOL. 157, NO. 1, (38-41), Online publication date: 1-Jan-1997.Netto N, de Almeida Claro J, Esteves S and Andrade E (2018) Ureteroscopic Stone Removal in the Distal Ureter. Why Change?Journal of Urology, VOL. 157, NO. 6, (2081-2083), Online publication date: 1-Jun-1997.Streem S (2018) Contemporary Clinical Practice of Shock Wave Lithotripsy: A Reevaluation of ContraindicationsJournal of Urology, VOL. 157, NO. 4, (1197-1203), Online publication date: 1-Apr-1997.Hosking D and Bard R (2018) Ureteroscopy with Intravenous Sedation for Treatment of Distal Ureteral Calculi: A Safe and Effective Alternative to Shock Wave LithotripsyJournal of Urology, VOL. 156, NO. 3, (899-902), Online publication date: 1-Sep-1996.Preminger G (2018) Editorial: Nephrolithiasis—Solutions for Emerging ProblemsJournal of Urology, VOL. 156, NO. 3, (910-911), Online publication date: 1-Sep-1996. (2018) EDITORIAL COMMENTJournal of Urology, VOL. 153, NO. 1, (36-36), Online publication date: 1-Jan-1995. Volume 152Issue 1July 1994Page: 62-65 Advertisement Copyright & Permissions© 1994 by The American Urological Association Education and Research, Inc.Keywordsextracorporeal shockwave lithotripsykidney calculiureteral calculiMetricsAuthor Information Kevin R. Anderson More articles by this author David W. Keetch More articles by this author David M. Albala More articles by this author Paramjit S. Chandhoke More articles by this author Bruce L. Mcclennan More articles by this author Ralph V. Clayman More articles by this author Expand All Advertisement Loading ...