Ureteral calculi: extracorporeal shock-wave lithotripsy performed in situ on an outpatient basis (original) (raw)

1992, World Journal of Urology

were subjected to extracorporeal shockwave lithotripsy (ESWL) performed in situ on an outpatient basis. Treatment was carried out without the need for anesthesia or sedation in 94070 of the cases and without a ureteral catheter in 97%. This approach was effective in 88°70 of the patients who showed radiological evidence of fragmentation at the end of the procedure, and 81°70 of the patients were stone-free at the 3-month follow-up. A second ESWL treatment was necessary in 10°70 of the patients, of whom 12% required either endourological procedures or open surgery. ESWL should be the first therapeutic choice for all kinds of ureteral stones, since it has proved its effectiveness, avoiding hospitalization, anesthesia, and endourological maneuvers. The surgical treatment of urinary lithiasis has developed intensively over the last decade, with traditional open surgery being replaced by endourological procedures. Noninvasive treatments such as extracorporeal shockwave lithotripsy (ESWL) were initially employed to treat renal stones as well as calculi in the upper ureter that were associated with transureteral retrograde stone manipulation. The present report describes our experience with ESWL for the treatment in situ of ureteral stones in any location, without the need for anesthesia, ureteral manipulation or hospitalization. Between July 1988 and July 1989, 192 patients with ureteral stones were treated by ESWL (Lithostar, Siemens), 178 of whom were followed radiologica/ly and clinically. A single stone was present in 184 cases, and 2 stones were found in 8, for a total of 200 calculi. In all, 87 (43.5%) were located on the right side and 113 (56,5%), on the left side; 131 of the patients were men (68,2%) and 61 were women (31,8%). All treat-