Shock wave lithotripsy as a primary modality for treating upper ureteric stones: A 10-year experience
Aims and Objectives: Shock wave lithotripsy (SWL) has been recommended as a first-line treatment for upper ureteric calculi in several studies with a success rate of 80-90%. Our aim is to present our retrospective data of treatment of upper ureteric stones with SWL as primary modality over a 10-year...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2008-01-01
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| Series: | Indian Journal of Urology |
| Subjects: | |
| Online Access: | http://www.indianjurol.com/article.asp?issn=0970-1591;year=2008;volume=24;issue=4;spage=486;epage=489;aulast=Padhye |
| Summary: | Aims and Objectives: Shock wave lithotripsy (SWL) has been recommended as a first-line treatment for upper ureteric calculi in several studies with a success rate of 80-90%. Our aim is to present our retrospective data of treatment of upper ureteric stones with SWL as primary modality over a 10-year period and evaluate the factors affecting fragmentation and clearance.
Materials and Methods: From February 1997 to March 2007, 846 patients with upper ureteric stones were treated with SWL as the primary modality. Age: 9-69 years, 546 males and 300 females, stone size: 7-22 mm. Pyuria in 132/846 with clinical infection 40/132, pre-SWL JJ stenting: 40/846 and anesthesia in 41/846 patients. Duration of symptoms: < 4 weeks- 780/846,> 4 weeks- 66/846. Stone size: < 1 cm- 513/846,> 1 cm-333/846. Workup: X-Ray KUB, Urine and Uro-USG. Intravenous urogram (IVU): 130/846. Intraoperative (C-arm) fluoroscopic imaging was used. Presentation: colic-801/846, incidental-45/846. Criteria for clearance: symptomatic relief, X-ray and USG confirmation.
Results: Clearance rate: < 1cm- 95.91% (492/513),> 1 cm- 85.29% (284/333). Overall clearance rate: 91.73% (776/846). No clearance: 70/846 (8.27 %). In these, 59/70 underwent ureteroscopy, 8/70 percutaneous nephrolithotomy and 3/70 open ureterolithotomy for clearance. Post SWL complications were seen in 25 (3%) cases with septicemia in nine and stein strasse in 16 cases. Duration of symptoms < 4 weeks - 93.7% success (731/780),> 4 weeks - 68.1% (45/66). Non-stented - 92% (744/806) success. Stented group-80% (32/40).
Conclusions: Best results with SWL as monotherapy for upper ureteric stones are achieved when stones are less than 1 cm in size, of short duration history and without indwelling stents. Overall success rate - 91.73%. |
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| ISSN: | 0970-1591 1998-3824 |