[Ureteral remote shockwave lithotripsy]

During 1-year exploitation of a Lithostar remote lithotriptor (Siemens) 221 patients with concrements of various parts of the ureter were treated. The patients' ages were from 6 to 86 years. It the course of treatment 170 patients needed only 1 session of remote shock wave ureterolithotripsy; 44--2 sessions; 5--3; and 2--4 sessions. The ureterolithotripsy was carried out under intravenous and local infiltrative anesthesia, as well as under intravenous analgesia or without any anesthesia. According to presence or absence of the inflammation process, the time a concrement stood in the same place, the severity of obstructive nephropathy the following ureterolithotripsy methods were used: 1) "on the spot" (in the absence of inflammation and duration of concrement standing in one place no more than 6-8 weeks); 2) in the presence of an ureteral catheter (in more prolonged periods of concrement standing); 3) in the presence of transcutaneous puncture nephrostomy (in inflammatory process and severe signs of obstructive uropathy). Better treatment results were obtained in patients with a small concrement standing period and in those whose ureter concrements were shifted or passed the catheter. The retro- or anterograde concrement perfusion by physiologic saline and diuretic therapy increased the efficacy of remote shock wave ureterolithotripsy. The therapy was effective in 206 of 221 patients (93.2%); in case of failures 7 patients underwent an open ureterolithotomy; 5--retrograde and 3--anterograde ureteral stone extraction or lithotripsy.

6 patients had a pyelonephritis attack because of fragments crashed stone renal occlusion; 3 were operated on by the method of transcutaneous paracentetic nephrostomy; other 3 patients' kidneys were catheterized.(ABSTRACT TRUNCATED AT 250 WORDS)