Humans ; Lithotripsy ; instrumentation ; methods ; Ureteral Calculi ; therapy

From April to October, 1988, 34 patients with ureteral calculi more than O.5 cm or smaller but impacted ureteral stone underwent pulsed dye laser lithotripsy under ureteroscopy. The results were as follows : 1. The locations of stone were upper ureter in 9(26.5%), mid ureter in 8(23.5%), lower ureter in 11(32.4%), and UVJ in 6(17.6%). 2. The success rates according to location were 66.7% in upper ureter, 87.5% in mid ureter, 91% in lower ureter, and 100% in UVJ and the average success rate was 85.3%. 3. The success rates according to stone size were 83% in 0.3-0.5 cm, 90% in 0.5-1.0 cm, and 75% in 1.0-2.3 cm. 4. The average procedure time was about 85 minutes, with a range of 30 to 120 minutes and the average hospitalization after laser therapy was about 3 days, with a range of 1 to 6 days. 5. There were 5 cases (14.8%) of failure due to upward migration of stone in 3 cases, ureteral injury in 1 case and ureteral stricture in 1 case. 6. Complications occurred in 10 patients (29.5 %), almost by ureteroscopy but laser induced complication was not found. Therefore, we confirm that laser lithotripsy is a safe and effective method for treatment of ureteral stone.
Constriction, Pathologic ; Hospitalization ; Humans ; Laser Therapy ; Lasers, Dye* ; Lithotripsy ; Lithotripsy, Laser ; Ureter* ; Ureteral Calculi* ; Ureteroscopy* ; Urinary Calculi

OBJECTIVETo prospectively evaluate the efficacy of Removing Stasis and Reducing Heat Formula in accelerating calculus clearance and improving lower urinary tract symptoms of patients with proximal ureteral calculi after ureteroscopic Ho:YAG laser lithotripsy.

METHODSA total of 138 patients with proximal ureteral calculi underwent ureteroscopic Ho:YAG laser lithotripsy by a single endocrinologist. Stone size varied from 10 to 15 mm. After operation, the patients were randomly divided into three groups: the control group (group A), tamsulosin group (group B), and Removing Stasis and Reducing Heat Formula group (group C). The treatment lasted for 4 weeks or until stone clearance. The primary and secondary outcomes of the three groups at follow-up were assessed.

RESULTSOf the 131 patients available for follow-up, 44 cases were in the group A, 45 in the group B, and 42 in the group C, respectively. The stone free rate at 2 weeks in the groups B and C were significantly higher than that in the group A (95.56%, 97.62% vs. 79.55%; all P<0.05). The ureteral colic rate and mean time of fragment expulsion were significantly reduced in the groups B (4.44% and 7.86±4.99 days) and C (2.43% and 6.76±4.37 days) compared with the group A (22.73% and 11.54±9.89 days, all P<0.05). On the day of double-J ureteric stent removal, the group C differed significantly from the group A in the total International Prostate Symptom Score, irritative subscore, obstructive subscore, and quality of life score (all P<0.05).

CONCLUSIONRemoving Stasis and Reducing Heat Formula in the medical expulsive therapy might be an effective modality for patients with calculus in the proximal uretera after ureteroscopic Ho:YAG laser lithotripsy.

Adult ; Female ; Humans ; Lithotripsy, Laser ; methods ; Male ; Middle Aged ; Prospective Studies ; Ureteral Calculi ; therapy ; Ureteroscopy ; methods

The effectiveness and safety of ureteroscopic holmium: YAG laser lithotripsy for managing ureteral calculi was evaluated. Ureteroscopic holmium. YAG laser lithotripsy was performed in 168 ureteral calculi (upper 27 cases, middle 33 cases and lower 108 cases). The results showed that the stone-free rate was 92.6% in the upper ureteral calculi, 93.9% in the middle ureteral calculi and 94.4% in the lower ureteral calculi, respectively. The complication rate was 4.8% (8 cases). It was suggested that ureteroscopic holmium: YAG laser lithotripsy is a highly effective and safe treatment modality for managing ureteral calculi.
Adult ; Aged ; Female ; Holmium ; Humans ; Lithotripsy, Laser ; methods ; Male ; Middle Aged ; Ureteral Calculi ; therapy ; Ureteroscopy

OBJECTIVETo evaluate the therapeutic effects of pneumatic lithotripsy on children urethral calculi.

METHODSTwenty-two cases of the male children with urethral calculi were treated with pneumatic lithotripsy under ureteroscopy.

RESULTSAll the patients were treated successfully in a single procedure. The time of lithotripsy was (5.5 +/- 2.2) minutes, and no serious complication such as obvious hematuria, infection and urethral stricture occurred.

CONCLUSIONSIt is suggested that pneumatic lithotripsy under ureteroscopy is an effective and simple way for the treatment of urethral calculi in children.

Adolescent ; Child ; Child, Preschool ; Humans ; Lithotripsy ; methods ; Male ; Ureteral Calculi ; therapy ; Ureteroscopy

OBJECTIVETo compare the efficacy and complication of ureteroscopic lithotripsy and ureteroscopic management for ureteral calculi after failed extracorporeal shock wave lithotripsy (ESWL).

METHODSOne hundred and thirty-six cases with ureteral calculi after failed ESWL and 189 cases with ureteral calculi were treated with ureteroscopic lithotripsy (URSL). Clinical data of two groups were analyzed retrospectively.

RESULTSThe mean operating time and therapeutic time in ESWL-URSL group was longer than that in URSL group, while the rate of polypi hyperplasia and open-surgery in ESWL-URSL group was 34.6%, 5.88% versus 28.3%, 1.59% in URSL group. There is no significant statistical difference in stone-free rate between two groups.

CONCLUSIONUreteroscopic management can be preferred for the patients with disadvantage of ESWL in some condition.

Adult ; Female ; Humans ; Lithotripsy ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Ureteral Calculi ; surgery ; therapy ; Ureteroscopy

OBJECTIVETo evaluate the availability of ballistic lithoclast in treatment of ureteral calculi.

METHODSTotally 625 patients with ureteral calculi were treated with ballistic lithoclast by rigid ureteroscopy.

RESULTSTotally 610 patients were treated successfully by ballistic lithoclast with a cure rate of 97.6% (90.3% in upper ureter, 96.8% in middle ureter, 100% in lower ureter). The average time of lithoclast was (5.0 +/- 2.8) minutes and the stone-free rate was 99.2%.

CONCLUSIONBallistic lithoclast combined with rigid ureteroscopy is safe and effective in treating ureteral calculi.

Adult ; Aged ; Female ; Humans ; Lithotripsy ; methods ; Male ; Middle Aged ; Treatment Outcome ; Ureteral Calculi ; therapy ; Ureteroscopes

OBJECTIVETo investigate the therapeutics of complex calculi in solitary kidney, and to improve the effect and safety of treatment.

METHODSExperiences in the treatment of 42 patients were summarized. All patients were with mould or multiple calculi, 8 cases were complicated with ureter calculi, and 6 cases were hospitalized because of obstructive anuria. The patients with mould calculi received extracorporal shock wave lithotripsy (ESWL) prior to percutaneous nephrolithotomy (PCNL). While the patients with multiple calculi received PCNL prior to ESWL. Some cases were treated by lithotripsy.

RESULTSThirty-six cases (86%) were cured by ESWL combined with PCNL. Eleven cases received lithotripsy during PCNL. The 6 cases with obstructive anuria recovered in 12 hours after emergent ESWL or lithotripsy; 6 cases (14%) underwent open operation because of deformity or obstruction in renal pelvis and ureter; 2 cases have to keep nephrostomy because of repeated infection. Followed up 6-18 months, 38 cases (86%) keep good kidney function; 5 cases (14%) had renal insufficiency; 4 cases (11%) reoccurred calculi.

CONCLUSIONSThe therapeutics of ESWL combined with PCNL may clear complex calculi of solitary kidney effectively and safe. It is necessary to take emergent ESWL in renal obstructive calculi cases. And the patients with lower ureter obstructive calculi may take lithotripsy first. It is proper to choose open operation on the patients with deformity of renal pelvis or obstruction of ureter.

Adult ; Combined Modality Therapy ; Female ; Humans ; Kidney ; abnormalities ; Kidney Calculi ; therapy ; Lithotripsy ; Male ; Middle Aged ; Nephrostomy, Percutaneous ; methods ; Retrospective Studies ; Treatment Outcome ; Ureteral Calculi ; therapy ; Ureteroscopy

OBJECTIVETo investigate the factors affecting the efficacy of extracorporeal shockwave lithotripsy (ESWL) for upper urinary tract stones.

METHODSBetween January 2003 and January 2006, 366 patients with upper urinary tract stone underwent ESWL, and the results were identified by regular KUB/IVU or ultrasonography and evaluated 3 months after the treatment. The treatment success was defined as complete clearance of the stones without residual fragments. The stone-free rate was analyzed in relation to the stone features and the patients' clinical characteristics, and the factors identified to significant affect the results were further analyzed using multivariate regression analysis.

RESULTSThree months after the treatment, the overall stone-free (success) rate was 63.4% (232/366) in these patients. Chi square test and t test identified the disease course, stone length and width as the factors with significant impact on the stone-free rate. Multivariate analysis excluded the disease course and stone width from the logistic regression model, and identified the stone length as the independent factor affecting the outcome of ESWL.

CONCLUSIONThe stone length is an independent factor influencing the efficacy of ESWL for upper urinary tract stones.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Humans ; Kidney Calculi ; therapy ; Lithotripsy ; methods ; Male ; Middle Aged ; Regression Analysis ; Treatment Outcome ; Ureteral Calculi ; therapy ; Young Adult

OBJECTIVETo evaluate the clinical efficacy of extracorporeal shockwave lithotripsy (ESWL) for bilateral ureteral stones with renal colic in emergency.

METHODSWe retrospectively analyzed the clinical data of 86 patients suffered with sudden renal colic due to bilateral ureteral stones and treated with ESWL between January 2005 and January 2009.

RESULTSThe success rate was 74.4% after a single ESWL session, and the overall success rate was 82.6%. Significant difference in stone length was observed between successful group and failed group (P<0.01). The stone position did not produce significant impact on the outcome of the treatment (P>0.05).

CONCLUSIONESWL is an effective treatment modality in emergency for small-length and short-term obstruction bilateral ureteral stones with remal colic.

Adolescent ; Adult ; Emergencies ; Female ; Humans ; Lithotripsy ; Male ; Middle Aged ; Renal Colic ; etiology ; therapy ; Ureteral Calculi ; complications ; therapy ; Young Adult