[Extracorporeal lithotripsy in lumbar ureteral lithiasis. Is the ureteral catheter necessary?]

To evaluate the efficacy of JJ catheter as urinary diversion in the treatment of lumbar ureteral lithiasis by ESWL.

Results obtained in our ESWL unit between january 1990 and October 2000 are compared. 680 cases of lithiasis are divided into 5 groups for analysis: Group A: Lumbar ureter non obstructive lithiasis. 200 cases. Group B: Lumbar ureter obstructive lithiasis without urinary diversion. 307 cases. Group C: Lumbar ureter obstructive lithiasis with JJ catheter. 90 cases. Group D: Lumbar ureter lithiasis with percutaneous nephrostomy. 32 cases. Group E: Lumbar ureter lithiasis pushed up to renal cavities by JJ catheter. 51 cases.

Groups are compared for stone size, number of ESWL sessions and average number of shock waves. Repeated ESWL, complications and success rates are also analyzed. Statistical analysis of these results and its comparison by 2 proportion comparison tests show that groups B and C are homogeneous in size. We analyze these groups for complete success rate, partial success, and fragmentation index; it is derived from this analysis that Group C maintains the same level of fragmentation but not fragment expulsion, being this due to the only difference between groups B and C, which is the JJ catheter.

In our series JJ catheter makes fragment expulsion difficult after treatment of the lumbar ureter lithiasis although it minimises the incidence of renal colic, the most frequent post-ESWL complication.