| RESEARCH ARTICLE |
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| Year : 2003 | Volume
: 20
| Issue : 1 | Page : 23-27 |
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Management of proximal ureteral stones - comparison of outpatient ureterolithotripsy with in-situ shock wave lithotripsy (SWL)
Harbans Singh, Vipul Tandon, US Dwivedi, Mufti Mahmood, Arif Hamid, Gopi Kishore, PB Singh
Department of Urology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
Correspondence Address:
P B Singh
Department of Urology, Institute of Medical Sciences, Banaras Hindu University, Varanasi - 221 005
India
 Source of Support: None, Conflict of Interest: None  | Check |
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Objectives: The aim of this study is to review the feasibility and effectiveness of ureteroscopy with intracorporeal lithotripsy under intravenous sedation on outpatient basis as a primary procedure in patients with proximal ureteral calculi and its comparison with in situ SWL.
Methods: From January 2000 to December 2001, 56 patients with proximal ureteral calculi underwent ureterolithotripsy and 32 patients underwent in situ shock wave lithotripsy (SWL). Ureterolithotripsy was performed with 8.0 Fr Wolf rigid ureteroscope and Swiss Lithoclast on daycare basis.
Results: In patients managed with ureterolithotripsy, stone was successfully reached and fragmented in 47(83.93%) patients. Complete stone fragmentation and spontaneous passage occurred in 40 (71.4%)patients with single session. Seven (12.5%) patients required more than one session for complete clearance. JJ stent was required in 13(23.2%) patients. One case of ureteral perforation was managed successfully with JJ stent. In SWL group, 28 (87.5%) patients became stone free at 3 months. Seventeen patients (53.2%) required retreatment and adjuvant procedure was done in 6 patients (18.7%).
Conclusions: Ureterolithotripsy and in situ SWL are equally effective for proximal ureteral stone. Ureterolithotripsy for proximal ureteral calculi has high success rate with low morbidity. It can be done safely with intravenous sedation and local anesthesia. Ureteroscopic stone removal can be considered as primary approach in patients with proximal ureteral calculi reserving SWL for those who can afford it. |
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