Management of Distal-Ureteral Stones

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Ureteroscopic pneumatic lithotripsy (URS-PL) has a high success rate in treating unilateral distal-ureteral stones, a study found.

 

Investigators followed 15 patients, of whom 10 had two stones, four had three stones, and one had five stones. The average stone size was 9.7 mm. Twelve patients (80%) were stone-free after the first treatment session; two patients required a second ureterscopy procedure for the remaining stone or failure of ureteral access. Fourteen patients (93.3%) became stone-free, researchers reported in the Journal of Endourology (2006;20:1022-1024). One patient had ureteral perforation as a major complication.

 

In the same journal (pp. 1025-1029), another team reported that when extracorporeal shockwave lithotripsy (SWL) fails, URS-PL is as safe and effective as primary ureteroscopy. They studied 375 patients with distal-ureteral stones treated with URS-PL, and divided them into two groups. Group 1 consisted of 213 patients treated with URS-PL primarily, and group 2 had 162 patients who underwent SWL unsuccessfully prior to URS-PL.

 

Successful treatment was observed in 206 patients (96.7%) in group 1 and 155 (95.6%) in group 2. Although stone-free rates differed on the first postoperative day, they were similar at the end of the first postoperative month.

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