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[Ureteroscopy (URS) for ureteric calculi].

R Hofmann1

  • 1Klinik für Urologie und Kinderurologie, Philipps-Universität, 35037, Marburg. R.Hofmann@med.uni-marburg.de

Der Urologe. Ausg. A
|April 6, 2006
PubMed
Summary

Ureteroscopic lithotripsy is effective for distal ureteral calculi, offering high success rates and low complications. Extracorporeal shock wave lithotripsy remains preferred for proximal stones.

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Area of Science:

  • Urology
  • Endourology

Context:

  • Distal ureteral calculi under 5 mm often pass spontaneously.
  • Ureteroscopic lithotripsy (URS) and extracorporeal shock wave lithotripsy (ESWL) are primary treatment modalities for ureteral stones.

Purpose:

  • To compare the efficacy and complication rates of URS versus ESWL for distal ureteral calculi.
  • To outline the indications and techniques for using flexible endoscopes with holmium:YAG laser and flexible Lithoclast.

Summary:

  • Ureteroscopic lithotripsy demonstrates high stone-free rates (9-11% overall complication rate) for distal ureteral calculi, comparable to ESWL.
  • ESWL is the preferred treatment for proximal ureteric stones.
  • Flexible endoscopes, used with holmium:YAG laser and flexible Lithoclast under fluoroscopic guidance, are effective for proximal ureter or renal collecting system stones.

Impact:

  • URS offers a safe and effective alternative to ESWL for distal ureteral stones.
  • Minimally invasive URS, when performed by skilled surgeons, has a low complication rate, with ureteral perforation and stricture being rare (<1%).
  • Understanding the nuances of different lithotripsy techniques optimizes patient outcomes and minimizes treatment-related morbidity.

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