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Endoscopic management of impacted ureteral stones using a small caliber ureteroscope and a laser lithotriptor.
J Urol. 2000 Aug; 164(2):329-31.JU

Abstract

PURPOSE

We reviewed our experience with retrograde endoscopy using a small caliber ureteroscope and a laser lithotriptor in 104 consecutive patients with impacted ureteral stones and also analyzed the associated endoscopic findings.

MATERIALS AND METHODS

From July 1993 to October 1999 we performed retrograde endoscopic treatment in 104 patients with impacted ureteral stones. Average maximum stone diameter was 15.2 mm. (range 2 to 110), and 9 patients had stones larger than 3 cm. Mean duration of impaction was more than 14 months and the longest was 10 years. We used 6.9Fr rigid or 6.9 to 7.5Fr flexible ureteroscopes and a pulsed dye laser or holmium:YAG laser lithotriptor.

RESULTS

Of the 104 ureteral stones 100 (96.2%) were completely fragmented by a single endoscopic procedure. Although 1 uric acid stone could not be disintegrated by either the pulsed dye laser or electrohydraulic lithotripsy early in this series, it was discharged spontaneously 2 weeks after the procedure. Additional extracorporeal shock wave lithotripsy (ESWL*) was required in 3 patients who initially had stones larger than 3 cm. A month after treatment no patient had evidence of residual stones. Using adjuvant ESWL a 100% success rate was attained with minimal morbidity. Endoscopic observation revealed inflammatory polyps of the ureter in 22 patients (21.2%), and stricture adjacent to the stone in 16 (15. 4%). There were no significant complications.

CONCLUSIONS

Using a small caliber ureteroscope and a laser lithotriptor we could treat the target stone in all 104 patients with adjuvant ESWL in 3 cases. Endoscopic lithotripsy seems to be effective first line therapy for chronically impacted stones which are frequently associated with chronic inflammation, polyps and strictures, and avoids the futile repetition of ESWL and problems related to the prolonged passage of stone fragments.

Authors+Show Affiliations

Department of Urology, Seirei Mikatahara General Hospital, Hamamatsu, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10893577

Citation

Mugiya, S, et al. "Endoscopic Management of Impacted Ureteral Stones Using a Small Caliber Ureteroscope and a Laser Lithotriptor." The Journal of Urology, vol. 164, no. 2, 2000, pp. 329-31.
Mugiya S, Nagata M, Un-No T, et al. Endoscopic management of impacted ureteral stones using a small caliber ureteroscope and a laser lithotriptor. J Urol. 2000;164(2):329-31.
Mugiya, S., Nagata, M., Un-No, T., Takayama, T., Suzuki, K., & Fujita, K. (2000). Endoscopic management of impacted ureteral stones using a small caliber ureteroscope and a laser lithotriptor. The Journal of Urology, 164(2), 329-31.
Mugiya S, et al. Endoscopic Management of Impacted Ureteral Stones Using a Small Caliber Ureteroscope and a Laser Lithotriptor. J Urol. 2000;164(2):329-31. PubMed PMID: 10893577.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic management of impacted ureteral stones using a small caliber ureteroscope and a laser lithotriptor. AU - Mugiya,S, AU - Nagata,M, AU - Un-No,T, AU - Takayama,T, AU - Suzuki,K, AU - Fujita,K, PY - 2000/7/14/pubmed PY - 2000/9/19/medline PY - 2000/7/14/entrez SP - 329 EP - 31 JF - The Journal of urology JO - J Urol VL - 164 IS - 2 N2 - PURPOSE: We reviewed our experience with retrograde endoscopy using a small caliber ureteroscope and a laser lithotriptor in 104 consecutive patients with impacted ureteral stones and also analyzed the associated endoscopic findings. MATERIALS AND METHODS: From July 1993 to October 1999 we performed retrograde endoscopic treatment in 104 patients with impacted ureteral stones. Average maximum stone diameter was 15.2 mm. (range 2 to 110), and 9 patients had stones larger than 3 cm. Mean duration of impaction was more than 14 months and the longest was 10 years. We used 6.9Fr rigid or 6.9 to 7.5Fr flexible ureteroscopes and a pulsed dye laser or holmium:YAG laser lithotriptor. RESULTS: Of the 104 ureteral stones 100 (96.2%) were completely fragmented by a single endoscopic procedure. Although 1 uric acid stone could not be disintegrated by either the pulsed dye laser or electrohydraulic lithotripsy early in this series, it was discharged spontaneously 2 weeks after the procedure. Additional extracorporeal shock wave lithotripsy (ESWL*) was required in 3 patients who initially had stones larger than 3 cm. A month after treatment no patient had evidence of residual stones. Using adjuvant ESWL a 100% success rate was attained with minimal morbidity. Endoscopic observation revealed inflammatory polyps of the ureter in 22 patients (21.2%), and stricture adjacent to the stone in 16 (15. 4%). There were no significant complications. CONCLUSIONS: Using a small caliber ureteroscope and a laser lithotriptor we could treat the target stone in all 104 patients with adjuvant ESWL in 3 cases. Endoscopic lithotripsy seems to be effective first line therapy for chronically impacted stones which are frequently associated with chronic inflammation, polyps and strictures, and avoids the futile repetition of ESWL and problems related to the prolonged passage of stone fragments. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/10893577/Endoscopic_management_of_impacted_ureteral_stones_using_a_small_caliber_ureteroscope_and_a_laser_lithotriptor_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-5347(05)67352-1 DB - PRIME DP - Unbound Medicine ER -