THE ROLE OF EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY ESWL IN THE TREATMENT OF UPPER URETERAL STONE DISEASE
AbstractPurpose: To evaluate the role of extracorporeal shock wave lithotripsy (ESWL) in the management of upper ureteral stones. Patients and methods Between May 2009 and June 2011, 115 patients with radio-opaque upper ureteral stones who referred to lithotripsy unit in Al-hussain teaching hospital in Thiqar, 83 male( average 48 years) and 32 female (average 51years), treated with extracorporeal shock wave lithotripsy (ESWL). The patients were discharged from the hospital on the same day of treatment and patients were asked to return after two weeks for fallow up plain film together with ultrasound examination, to be able to detect fragmentation and stone clearance together with the effect of treatment and obstruction on the upper tract. Results The over all success rate for the patient at 3 months of follow up was 64.3% (74 pt.) the success rate decreases as the stone size increases. It decrease from 76% to patients with stone <10 mm to only 52% to patients with stone > 15mm. The remaining 41 patients (35.6%) were considered failure, either due to non fragmentation of the stone despite repeated sessions (3 sessions) or fragments are large that failed to pass (5 cases). All patients were treated on an outpatient basis; the complications were minimal and treated conservatively. Conclusions ESWL is safe, effective, noninvasive and a convenient way of treatment for upper ureteral stones. ESWL being an outpatient procedure without any need for anesthesia or any pretreatment intervention, it should be considered as the first line of treatment for all stones in the upper ureter. However the clearance rates for stones larger than 15 mm were low.
Seitz C, Fajcovic H, Remzi M, Waldert M, Ozsoy M. Rapid extracorporeal shock wave lithotripsy treatment after a first colic episode correlates with accelerated ureteral stone clearance. Eur Urol 2006;49:1099-106.
Arrabal-Martín M, Pareja-Vilches M, Gutiérrez-Tejero F, Miján-Ortiz JL, Palao-Yago F, Zuluaga-Gómez A: Therapeutic options in lithiasis of the lumbar ureter. Eur Urol. 2003; 43: 556-63.
Gettman MT, Segura JW: Management of ureteric stones: issues and controversies. BJU Int. 2005; 95 (Suppl 2): 85-93.
Tligui M, El Khadime MR, Tchala K, Haab F, Traxer O, Gattegno B, et al.: Emergency extracorporeal shock wave lithotripsy (ESWL) for obstructing ureteral stones. Eur Urol. 2003; 43: 552-5.
Deliveliotis C, Chrisofos M, Albanis S, Serafetinides E, Varkarakis J, Protogerou V: Management and fol¬low-up of impacted ureteral stones. Urol Int. 2003; 70: 269-72.
Hochreiter WW, Danuser H, Perrig M, Studer UE: Ex¬tracorporeal shock wave lithotripsy for distal ureteral calculi: what a powerful machine can achieve. J Urol. 2003; 169: 878-80.
LIU Hui.The People's Hospital of Guangning County,Guangdong 526300,China;The Comparison Between Ureteroscopic Lithotripsy and Retroperitoneal Laparoscopic Ureterolithotomy for treatment of Upper Ureteral Calculus[J];Journal of Bethune Military Medical College;2007-04
Tombal B, Mawlawi H, Feyaerts A, Wese FX, Opsomer R, Van Cangh PJ: Prospective randomized evaluation of emergency extracorporeal shock wave lithotripsy (ESWL) on the short-time outcome of symptomatic ureteral stones. Eur Urol. 2005; 47: 855-9.
Ghalayini IF, Al-Ghazo MA, Khader YS: Extracor¬poreal shockwave lithotripsy versus ureteroscopy for ureteric calculi: efficacy and patient satisfaction. Int Braz J Urol. 2006; 32: 656-64.
Coll DM, Varanelli MJ, Smith RC. Relationship of spontaneous passage of ureteral calculi to stone size and location as revealed by unenhanced helical CT. Am J Roentgenol 2002;178:101-3.
Micali S, Grande M, Sighinolfi MC, De Stefani S, Bianchi G. Efficacy of expulsive therapy using nifedipine or tamsulosin, both associated with ketoprofene, after shock wave lithotripsy of ureteral stones. Urol Res. Jun 2007;35(3):133-7.
Preminger GM, Tiselius HG, Assimos DG, Alken P, Buck C, Gallucci M, et al. 2007 Guidelines for the management of ureteral calculi. J Urol 2007;178:2418-34
Pareek G, Armenakas NA, Fracchia JA. Hounsfield units on computerized tomography predict stone-free rates after extracorporeal shock wave lithotripsy. J Urol. May 2003;169(5):1679-81.
Abe T, Akakura K, Kawaguchi M, Ueda T, Ichikawa T, Ito H, et al. Outcomes of shockwave lithotripsy for upper urinary-tract stones: a large-scale study at a single institution. J Endourol. Sep 2005;19(7):768-73.
Galvin D, Pearle MS. The contemporary management of renal and ureteral calculi. Br J Urol Int 2006;98(6): 1283-8.
Tang Bingjie, Tang Yongfeng, Yuan Linxi, et al;Clinical analysis of ESWL treatment of renal calculi[J];Guangzhou Medical Journal;2007-03
Kim FJ, Rice KR. Prediction of shockwave failure in patients with urinary tract stones. Curr Opin Urol. Mar 2006;16(2):88-92.
Lindqvist K, Holmberg G, Peeker R, Grenabo L. Extracorporeal shock-wave lithotripsy or ureteroscopy as primary treatment for ureteric stones: a retrospective study comparing two different treatment strategies. Scand J Urol Nephrol. 2006;40(2):113-8.
Weiland D, Lee C, Ugarte R, Monga M. Impact of shockwave coupling on efficacy of extracorporeal shockwave lithotripsy. J Endourol. Feb 2007;21(2):137-40.
Portis AJ, Yan Y, Pattaras JG, Andreoni C, Moore R, Clayman RV.
Matched pair analysis of shock wave lithotripsy effectiveness for comparison of lithotriptors. Journal of Urology 2003;169(1):58–62.
Lee YH, Tsai JY, Jiaan BP, Wu T, Yu CC. Prospective randomized trial comparing shock wave lithotripsy and ureteroscopic lithotripsy for management of large upper third ureteral stones. Urology. Mar 2006;67(3):480-4; discussion 484.
Lingeman JE, Kim SC, Kuo RL, McAteer JA, Evan AP. Shockwave lithotripsy: anecdotes and insights. J Endourol. Nov 2003;17(9):687-93.
Kim FJ, Rice KR. Prediction of shockwave failure in patients with urinary tract stones. Current Opinion in Urology 2006;16(2):88–92.
Chacko J, Moore M, Sankey N, Chandhoke PS. Does a slower treatment rate impact the efficacy of extracorporeal shock wave lithotripsy for solitary kidney or ureteral stones?. J Urol. Apr 2006;175(4):1370-3; discussion 1373-4.
Gupta NP, Ansari MS, Kesarvani P, Kapoor A, Mukhopadhyay S. Role of computed tomography with no contrast medium enhancement in predicting the outcome of extracorporeal shock wave lithotripsy for urinary calculi. Br J Urol Int 2005;95:1285-8.
Auge BK, Preminger GM. Update on shock wave lithotripsy technology. Curr Opin Urol. Jul 2002;12(4):287-90.
Madaan S, Joyce AD. Limitations of extracorporeal shock wave lithotripsy. Curr Opin Urol. Mar 2007;17(2):109-13.
WANG Jian,Zhang Hai-bin,XU Wen-feng,et al.Department of Urology,The First People's Hospital of Foshan,Foshan 528000,China;Clinical analysis of difficulties of ureteral calculi with ureteroscopic pneumatic lithotripsy[J];International Medicine & Health Guidance News;2009-10
Lee C, Ugarte R, Best S, Monga M. Impact of renal function on efficacy of extracorporeal shockwave lithotripsy. J Endourol. May 2007;21(5):490-3.
Chew BH, Knudsen BE, Denstedt JD. The use of stents in contemporary urology. Curr Opin Urol 2004;14:111-5.
Macaluso JN: Shock Wave Lithotripsy for Stones in the Ureter. Business Briefing: North America Pharmacotherapy; 85-88, April 2004
Putman SS, Hamilton BD, Johnson DB. The use of shock wave lithotripsy for renal calculi. Curr Opin Urol. Mar 2004;14(2):117-21.
Pearle MS, Lingeman JE, Leveillee R, Kuo R, Preminger GM, Nadler RB, Macaluso JN, Monga M, Kumar U, Dushinski J, Albala DM, Wolf JS, Assimos D, Fabrizio M, Munch LC, Nakada SY, Auge B, Honey J, Ogan K, Pattaras J, McDougall EM, Averch TD, Turk T, Pietrow P, and Watkins S: Prospective, randomized trial comparing shock wave lithotripsy and ureteroscopy for lower pole caliceal calculi 1 cm or less. The Journal of urology 173(6):2005-9 2005 Jun
Jeon SS, Hyun JH, LEE KS. A comparison of holmium:YAG laser with Lithoclast lithotripsy in ureteral calculi fragmentation. Int J Urol 2005;12(6):544-7.
Johnson DB, Pearle MS. Complications of ureteroscopy Urol Clin North Am 2004;31:157-71.
Karami H, Arbab AHMM, Hosseini SJ, Razzaghi MR, Simaei NR. Impacted upper-ureteral calculi >1 cm: blind access and totally tubeless percutaneous antegrade removal or retrograde approach? J Endourol. 2006;20
Goel R, Kesarwani PK, Gupta NP. Percutaneous antegrade removal of impacted upper-ureteral calculi: still the treatment of choice in developing countries. J Endourol 2005;19:54-7.
LIU Shu-qing,QU Guo-xin,WANG Li-qin,et al.The Worker's Hospital of Henan Province,Zhengzhou 450002,China;Retroperitoneal laparoscopic ureterolithotomy:with a report of 28 cases[J];Journal of Laparoscopic Surgery;2007-05
LIU Qi-zhong,TIAN Kai,SUN Qiang,et al.Dept.of Urology,Center Hospital of Luohe,Luohe 462000,China;The technique of transperitoneal laparoscopic ureterolithotomy for treatment of ureteral calculi[J];Journal of Laparoscopic Surgery;2008-03
LI Xun 1 HE Zhaohui 1 ZENG Guohua 1 CHEN Wenzhong 1 WU Kaijun 1 SHAN Zhichang 1 YUAN Jian 1;The current therapy of upper urinary tract calculi: report of 5178 patients[J];Journal of Clinical Urology;2004-06
Krambeck AE, Gettman MT, Rohlinger AL, Lohse CM, Patterson DE, Segura JW. Diabetes mellitus and hypertension associated with shock wave lithotripsy of renal and proximal ureteral stones at 19 years of followup. J Urol. May 2006;175(5):1742-7.
Pareek G, Armenakas NA, Panagopoulos G, Bruno JJ, Fracchia JA. Extracorporeal shock wave lithotripsy success based on body mass index and Hounsfield units. Urology 2005;65(1):33–6.
Sheir KZ, El-Diasty TA, Ismail AM. Evaluation of a synchronous twin-pulse technique for shock wave lithotripsy: the first prospective clinical study. BJU International 2005;95(3):38993.
Collins JW, Keeley FX. Is there a role for prophylactic shock wave lithotripsy for asymptomatic calyceal stones? Curr Opin Urol. Jul 2002;12(4):281-6.
Sheir KZ, Madbouly K, Elsobky E, Abdelkhalek M. Extracorporeal shock wave lithotripsy in anomalous kidneys: 11-year experience with two second-generation lithotripters. Urology. Jul 2003;62(1):10-5; discussion 15-6.
Pace KT, Ghiculete D, Harju M, Honey RJ. Shock wave lithotripsy at 60 or 120 shocks per minute: a randomized, double-blind trial. Journal of Urology 2005;174(2):595–9.
Seitz C, Tanovic E, Kikic Z, Memarsadeghi M, Fajcovic H. Rapid extracorporeal shock wave lithotripsy for proximal ureteral calculi in colic and non-colic patients. Eur Urol [in press]. Doi:10.1016/j.eururo.2007.02.001.
Tombal B, Mawlawi H, Feyaerts A, Wese FX, Opsomer R, Van Cangh PJ. Prospective randomized evaluation of emergency extracorporeal shock wave lithotripsy (ESWL ) on the short-time outcome of symptomatic ureteral
stones. Eur Urol 2005;4:855-9.
ZHANG Jing-zhong1, WANG Kun-feng1, HOU Zhen-yu1, ZHANG Chao2, WANG Wang-he2(1. Department of Laparocopic Surgery, 154 Hospital of Xinyang, Xinyang, Henan 464000, P.R.China; 2. Henan Laparoscopic Center, Zhengzhou, Henan 45000, P.R.China);Retroperitoneal laparoscopic ureterolithotomy[J];China Journal of Endoscopy;2004-10
Kravchic S, Bubkin I, Stepnov E, Peled R, Agulansy L, Cytron S. Emergency extracorporeal shock wave lithotripsy for acute renal colic caused by upper urinary-tract stones. J Endourol 2005;19:1-4.
LIU Jin-da,ZHANG Kai,SHAO Yu-lan,et al.Dept.of Urology,the Second Hospital of Chaoyang City,Chaoyang 122000,China;Experience of laparoscopic ureterolithotomy:with a report of 38 cases[J];Journal of Laparoscopic Surgery;2009-05
Anagnostou T, Tolley D. Management of ureteric stones. Eur Urol. Jun 2004;45(6):714-21.
Sheir KZ, El-Diasty TA, Ismail AM. Evaluation of a synchronous twin-pulse technique for shock wave lithotripsy: the first prospective clinical study. BJU Int. Feb 2005;95(3):389-93.