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Use of the Stone Cone for prevention of calculus retropulsion during holmium:YAG laser lithotripsy: case series and review of the literature.
Urol Int. 2009; 82(3):356-60.UI

Abstract

BACKGROUND

Stone retropulsion during ureteroscopic lithotripsy leads to additional procedures for residual calculi. The Stone Cone (Boston Scientific, Natick, Mass., USA) is a device designed to prevent stone migration.

OBJECTIVE

To determine the incidence of calculus retropulsion and additional procedures after ureteroscopy with intracorporeal lithotripsy while using the Stone Cone.

MATERIALS AND METHODS

A retrospective review of patients with obstructing ureteral calculi who underwent ureteroscopy and holmium:YAG laser lithotripsy using the Stone Cone as a backstop over a 3-year period at an academic medical center was performed. 133 patients underwent ureteroscopy with holmium:YAG laser lithotripsy using the Stone Cone to prevent calculus retroplusion. Success was defined as no residual fragments >2 mm in size, no changes from semirigid to flexible ureteroscope, and no additional procedures. Post-operative imaging was abdominal plain radiography or computed tomography. A MEDLINE search was performed to indentify all English clinical studies of the Stone Cone.

RESULTS

Of the 133 uses of the Stone Cone, there were 2 (1.5%) residual retropulsed fragments >2 mm which required an additional procedure. There were no changes to flexible ureteroscope secondary to stone retropulsion in 105 cases of semirigid ureteroscopy. There was no instance of ureteral obstruction from residual 2-mm fragments. There were no ureteral strictures or hydronephrosis among 91 patients with long-term follow-up imaging. A review of the literature was performed which yielded 4 clinical publications and 90 reported cases using the Stone Cone with 100% success. Two of these studies showed statistically significant improvement when compared with control patients.

CONCLUSIONS

The Stone Cone minimized stone retropulsion during ureteroscopic laser lithotripsy. The Stone Cone offers the urologist greater certainty during ureteroscopy and may decrease the number of clinically significant residual calculi.

Authors+Show Affiliations

Kidney Stone Center, Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. beisner@partners.orgNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19440028

Citation

Eisner, Brian H., and Stephen P. Dretler. "Use of the Stone Cone for Prevention of Calculus Retropulsion During holmium:YAG Laser Lithotripsy: Case Series and Review of the Literature." Urologia Internationalis, vol. 82, no. 3, 2009, pp. 356-60.
Eisner BH, Dretler SP. Use of the Stone Cone for prevention of calculus retropulsion during holmium:YAG laser lithotripsy: case series and review of the literature. Urol Int. 2009;82(3):356-60.
Eisner, B. H., & Dretler, S. P. (2009). Use of the Stone Cone for prevention of calculus retropulsion during holmium:YAG laser lithotripsy: case series and review of the literature. Urologia Internationalis, 82(3), 356-60. https://doi.org/10.1159/000209372
Eisner BH, Dretler SP. Use of the Stone Cone for Prevention of Calculus Retropulsion During holmium:YAG Laser Lithotripsy: Case Series and Review of the Literature. Urol Int. 2009;82(3):356-60. PubMed PMID: 19440028.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of the Stone Cone for prevention of calculus retropulsion during holmium:YAG laser lithotripsy: case series and review of the literature. AU - Eisner,Brian H, AU - Dretler,Stephen P, Y1 - 2009/05/11/ PY - 2008/01/23/received PY - 2008/02/26/accepted PY - 2009/5/15/entrez PY - 2009/5/15/pubmed PY - 2009/7/18/medline SP - 356 EP - 60 JF - Urologia internationalis JO - Urol. Int. VL - 82 IS - 3 N2 - BACKGROUND: Stone retropulsion during ureteroscopic lithotripsy leads to additional procedures for residual calculi. The Stone Cone (Boston Scientific, Natick, Mass., USA) is a device designed to prevent stone migration. OBJECTIVE: To determine the incidence of calculus retropulsion and additional procedures after ureteroscopy with intracorporeal lithotripsy while using the Stone Cone. MATERIALS AND METHODS: A retrospective review of patients with obstructing ureteral calculi who underwent ureteroscopy and holmium:YAG laser lithotripsy using the Stone Cone as a backstop over a 3-year period at an academic medical center was performed. 133 patients underwent ureteroscopy with holmium:YAG laser lithotripsy using the Stone Cone to prevent calculus retroplusion. Success was defined as no residual fragments >2 mm in size, no changes from semirigid to flexible ureteroscope, and no additional procedures. Post-operative imaging was abdominal plain radiography or computed tomography. A MEDLINE search was performed to indentify all English clinical studies of the Stone Cone. RESULTS: Of the 133 uses of the Stone Cone, there were 2 (1.5%) residual retropulsed fragments >2 mm which required an additional procedure. There were no changes to flexible ureteroscope secondary to stone retropulsion in 105 cases of semirigid ureteroscopy. There was no instance of ureteral obstruction from residual 2-mm fragments. There were no ureteral strictures or hydronephrosis among 91 patients with long-term follow-up imaging. A review of the literature was performed which yielded 4 clinical publications and 90 reported cases using the Stone Cone with 100% success. Two of these studies showed statistically significant improvement when compared with control patients. CONCLUSIONS: The Stone Cone minimized stone retropulsion during ureteroscopic laser lithotripsy. The Stone Cone offers the urologist greater certainty during ureteroscopy and may decrease the number of clinically significant residual calculi. SN - 1423-0399 UR - https://www.unboundmedicine.com/medline/citation/19440028/Use_of_the_Stone_Cone_for_prevention_of_calculus_retropulsion_during_holmium:YAG_laser_lithotripsy:_case_series_and_review_of_the_literature_ L2 - https://www.karger.com?DOI=10.1159/000209372 DB - PRIME DP - Unbound Medicine ER -