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[Ureteral lithiasis. Analysis of 3 series]
M Arrabal Martín1, E Camacho Martínez, P Campoy Martínez
1Servicio de Urología, Hospital Universitario de Valme, Sevilla.
Actas Urologicas Espanolas
|June 1, 1992
Summary
Extracorporeal shock wave lithotripsy (ESWL) is effective for simple ureteral stones (Type I). Complex stones (Type II and III) require advanced techniques like ureteroscopy for successful treatment.
Area of Science:
- Urology
- Nephrology
Background:
- Ureteral lithiasis presents a significant clinical challenge.
- Treatment modalities have evolved, necessitating comparative analysis.
Purpose of the Study:
- To evaluate the efficacy of different treatment strategies for ureteral lithiasis.
- To establish a grading system for ureteral calculi based on characteristics and location.
- To guide treatment selection for various types of ureteral stones.
Main Methods:
- Retrospective analysis of 1000 ureteral lithiasis cases over five years.
- Treatment modalities included Extracorporeal Shock Wave Lithotripsy (ESWL), ureteroscopy, and ureterolitotomy.
- Calculi characteristics, excretory tract, and renal function were assessed to develop a grading system (Types I, II, III).
Main Results:
- Type I (simple) ureteral lithiasis demonstrated high success rates with 'in situ' ESWL.
- Type II (complex lumbar ureter) lithiasis showed insufficient results with 'in situ' ESWL alone, requiring adjunctive endourological techniques.
- Type III (complex iliopelvian ureter) lithiasis was best managed with ureteroscopy.
Conclusions:
- 'In situ' ESWL is the preferred first-line treatment for simple ureteral stones (Type I).
- Complex ureteral stones, particularly in the lumbar and iliopelvian regions (Types II and III), necessitate advanced endourological interventions.
- A tailored approach based on stone type and location optimizes treatment outcomes for ureteral lithiasis.