Does Failure to Visualize the Ureter Distal to an Impacted Calculus Constitute an Impediment to Successful Lithotripsy?
- 1 June 2004
- journal article
- research article
- Published by Mary Ann Liebert Inc in Journal of Endourology
- Vol. 18 (5), 431-435
- https://doi.org/10.1089/0892779041271625
Abstract
Background : A severe degree of ureteral obstruction is viewed as a predictor of poor outcome in shockwave lithotripsy (SWL). Impacted stones are often considered a contraindication to in-situ SWL. Patients and Methods : Impaction in our study was defined as failure to visualize the ureter distal to the calculus with proximal hold-up of contrast for as long as 3 hours on an intravenous urogram (IVU). We evaluated 30 patients with impacted ureteral calculi, who were compared with a second unimpacted group matched for stone size and stone location. The calculi were reorganized into ≤10-mm and >10-mm groups. The results were compared in terms of clearance rates, number of shockwaves, number of sessions, and number of days between the start of SWL and clearance. Results : Between January 1998 and December 2001, 30 impacted stones were treated with lithotripsy. Complete clearance rates in the impacted as well as the non-impacted group were 76.7%. There was no statistical difference in the number of shockwaves, sessions, or time to clearance. The results were poorer in lower-ureteral than upper-ureteral calculi, but this difference did not reach statistical significance. However, the differences between the ≤10-mm and >10-mm stones were statistically significant. Conclusion : Impaction on an IVU does not affect the results of lithotripsy.Keywords
This publication has 15 references indexed in Scilit:
- Guidelines on Urolithiasis1European Urology, 2001
- URETERAL STONES CLINICAL GUIDELINES PANEL SUMMARY REPORT ON THE MANAGEMENT OF URETERAL CALCULIJournal of Urology, 1997
- Optimal Therapy for the Distal Ureteral Stone: Extracorporeal Shock Wave Lithotripsy Versus UreteroscopyJournal of Urology, 1994
- Management of Ureteric StonesEuropean Urology, 1994
- Extracorporeal Shock Wave Lithotripsy for Ureteral CalculiJournal of Urology, 1992
- Antegrade Ureterolitholapaxy in the Treatment of Obstructing or Incarcerated Proximal Ureteric StonesBJU International, 1990
- Management of the Impacted Ureteral CalculusJournal of Urology, 1990
- Treatment Options for Proximal Ureteral Urolithiasis: Review and RecommendationsJournal of Urology, 1989
- Treatment of Distai Ureteral Calculi with Extracorporeal Shock Wave Lithotripsy Experience with 264 CasesEuropean Urology, 1989
- Primary Choice of Intervention for Distal Ureteric Stone: Ureteroscopy or ESWL?BJU International, 1988