Treatment of proximal ureteral stones: a comparison study among extracorporeal shock wave lithotripsy, retrograde ureterolithotripsy and percutaneous ureterolithotripsy
- VernacularTitle:体外冲击波碎石、逆行输尿管镜或微创经皮输尿管镜碎石治输尿管上段结石的疗效比较
- Author:
Xiaowen SUN
;
Shujie XIA
;
Jun LU
;
Jie FAN
;
Wei WEN
;
Jie ZHANG
;
Haitao LIU
;
Weiguo LI
;
Yiyong ZHU
;
Zhongzhong LI
- Publication Type:Journal Article
- Keywords:
Urinary calculi;
Endoscopic surgery;
Surgical procedures,elective
- From:
Chinese Journal of Urology
2008;29(8):553-556
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effectiveness of extracorporeal shock wave lithotripsy (ESWL), retrograde ureterolithotripsy(URSL) and percutaneous ureterolithotripsy(PCL) in the treatment of proximal ureteral calculi. Methods A total of 397 patients with proximal ureteral calculi treated by ESWL,URSL or PCL ftom September 2001 to December 2005 were retrospectively analyzed. Results Among 397 patients,83 patients with a mean stone size of 1.23 cm were treated by ESW L.Of then.13 patients transferred to URSL or ureterolithotomy and the stone-free rate of ESWL 1 month later was 65.7%(46/70).TWO hundred and thirteen patients with a mean stone size of 1.21 cm were treated by URSL and 101 patients with a mean stone size of 1.50 cm were treated by PCL.The stone-free rate of URSL and PCL 1 month after the treatment was 88.2%(172/195)and 96.9%(95/98),respectively.Eighteen patients in URSL group and 3 patients in PCL group trans-ferred to ureterolithotomy.ESWL had a statistically lower stone-free rate than that of URSL and PCL (P＜0.001),both in patients with stone size≤1 cm and＞1 cm.For patients with stone size＞1 cm,PCL achieved a higher stone-free rate than URSL(P=0.005).PCL also had a higher stone-free rate than URSL in treating patients with stone size≤1 cm but there was no statistical difference between them. Conclusions ESWL can still be used as first-line treatment choice for proximal ureteral stones less than 1cm.For patients with proximal ureteral stones larger than 1cm.URSL and PCL are more proper treatment modalities since they can achieve higher stone-free rate and have acceptable low complications.
