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Ureteral stone disease. Options for management.

S P Dretler1

  • 1Harvard Medical School, Massachusetts General Hospital, Boston.

The Urologic Clinics of North America
|February 1, 1990
PubMed
Summary

Ureterolithotomy remains the most common treatment for ureteral stones globally due to limited access to advanced technologies like extracorporeal shock wave lithotripsy (ESWL). Operator skill and technology availability dictate the best surgical approach.

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Area of Science:

  • Urology
  • Surgical Techniques
  • Medical Technology Access

Background:

  • Management of ureteral stones depends heavily on surgeon expertise and available technology.
  • Global access to advanced treatments like extracorporeal shock wave lithotripsy (ESWL) is severely limited, with less than 1 billion people expected to have access in the future.

Purpose of the Study:

  • To analyze the current global prevalence of different surgical techniques for ureteral stone management.
  • To highlight the disparity in access to advanced ureteral stone treatment modalities worldwide.

Main Methods:

  • Analysis of global population data and projected access to ESWL.
  • Inference on the likely prevalence of ureterolithotomy based on technological and skill accessibility.

Main Results:

  • Extracorporeal shock wave lithotripsy (ESWL) is inaccessible to the vast majority of the global population.
  • The availability of skilled ureteroscopists is unknown but presumed to be limited.
  • Ureterolithotomy is likely the most frequently performed procedure for ureteral calculi worldwide.

Conclusions:

  • Despite technological advancements, ureterolithotomy remains the most common surgical intervention for ureteral stones globally.
  • Limited access to ESWL and potentially skilled ureteroscopists necessitates reliance on traditional methods in many regions.

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