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Ureteroscopic treatment of lower pole calculi: comparison of lithotripsy in situ and after displacement.
J Urol. 2002 Jul; 168(1):43-5.JU

Abstract

PURPOSE

Ureteroscopic management is a viable option for lower pole calculi less than 2 cm. Recently a technique was described to displace the calculus into a more accessible calix using a nitinol basket or grasper before lithotripsy. We compared the efficacy and safety of this technique with in situ treatment of small and intermediate lower pole calculi.

MATERIALS AND METHODS

We retrospectively reviewed the records of 95 ureteroscopy cases performed at our institution from January 1997 through August 2001 for renal calculi located only in the lower pole. Preoperative patient characteristics, stone size, operative details, complications and outcomes were compared for calculi treated in situ and those displaced before treatment.

RESULTS

Adequate followup was available on 78 patients. Patients in the displacement group were statistically older, more often had a preoperative indwelling ureteral stent and had a mean operative time that was 16 minutes longer (p = 0.04). Average stone diameter in the in situ and displacement groups was 8 and 10.3 mm., respectively (p = 0.04). In patients with radiographic followup greater than 1 month complete success was obtained for 77% of stones 1 cm. or less treated in situ versus 89% treated with displacement first (p = 0.43). For calculi greater than 1 cm. complete success was obtained for 2 of the 7 (29%) treated in situ versus all 7 (100%) treated with displacement (p = 0.005).

CONCLUSIONS

When treating lower pole calculi 1 to 2 cm. via ureteroscopy, a higher success rate can be obtained with displacement into a more accessible calix before treatment.

Authors+Show Affiliations

Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12050489

Citation

Schuster, Timothy G., et al. "Ureteroscopic Treatment of Lower Pole Calculi: Comparison of Lithotripsy in Situ and After Displacement." The Journal of Urology, vol. 168, no. 1, 2002, pp. 43-5.
Schuster TG, Hollenbeck BK, Faerber GJ, et al. Ureteroscopic treatment of lower pole calculi: comparison of lithotripsy in situ and after displacement. J Urol. 2002;168(1):43-5.
Schuster, T. G., Hollenbeck, B. K., Faerber, G. J., & Wolf, J. S. (2002). Ureteroscopic treatment of lower pole calculi: comparison of lithotripsy in situ and after displacement. The Journal of Urology, 168(1), 43-5.
Schuster TG, et al. Ureteroscopic Treatment of Lower Pole Calculi: Comparison of Lithotripsy in Situ and After Displacement. J Urol. 2002;168(1):43-5. PubMed PMID: 12050489.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ureteroscopic treatment of lower pole calculi: comparison of lithotripsy in situ and after displacement. AU - Schuster,Timothy G, AU - Hollenbeck,Brent K, AU - Faerber,Gary J, AU - Wolf,J Stuart,Jr PY - 2002/6/7/pubmed PY - 2002/7/9/medline PY - 2002/6/7/entrez SP - 43 EP - 5 JF - The Journal of urology JO - J Urol VL - 168 IS - 1 N2 - PURPOSE: Ureteroscopic management is a viable option for lower pole calculi less than 2 cm. Recently a technique was described to displace the calculus into a more accessible calix using a nitinol basket or grasper before lithotripsy. We compared the efficacy and safety of this technique with in situ treatment of small and intermediate lower pole calculi. MATERIALS AND METHODS: We retrospectively reviewed the records of 95 ureteroscopy cases performed at our institution from January 1997 through August 2001 for renal calculi located only in the lower pole. Preoperative patient characteristics, stone size, operative details, complications and outcomes were compared for calculi treated in situ and those displaced before treatment. RESULTS: Adequate followup was available on 78 patients. Patients in the displacement group were statistically older, more often had a preoperative indwelling ureteral stent and had a mean operative time that was 16 minutes longer (p = 0.04). Average stone diameter in the in situ and displacement groups was 8 and 10.3 mm., respectively (p = 0.04). In patients with radiographic followup greater than 1 month complete success was obtained for 77% of stones 1 cm. or less treated in situ versus 89% treated with displacement first (p = 0.43). For calculi greater than 1 cm. complete success was obtained for 2 of the 7 (29%) treated in situ versus all 7 (100%) treated with displacement (p = 0.005). CONCLUSIONS: When treating lower pole calculi 1 to 2 cm. via ureteroscopy, a higher success rate can be obtained with displacement into a more accessible calix before treatment. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/12050489/Ureteroscopic_treatment_of_lower_pole_calculi:_comparison_of_lithotripsy_in_situ_and_after_displacement_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-5347(05)64828-8 DB - PRIME DP - Unbound Medicine ER -