Fiberoptic transurethral lithotripsy prefers smaller impacted ureteral calculi rather than large renal stones.
A total of 30 patients with urolithiasis underwent 35 sessions of fiberoptic transurethral lithotripsy (f-TUL) involving electrohydraulic lithotripsy. There were 11 patients with nephrolithiasis including 4 with staghorn calculi and 19 patients with ureterolithiasis which were all located above the pelvic brim. A fiberoptic nephroureteroscope (URF-P) was successfully introduced up to the stone in all but 2 cases (93.3%). Of the 28 patients with successful introduction, 21 received a single session of f-TUL for complete fragmentation of their stones, which measured less than 16 x 9 mm by radiography. Three patients with larger renal stones (greater than or equal to 17 x 9 mm) underwent 2 sessions of f-TUL for complete fragmentation. The remaining 4 patients who had staghorn calculi (greater than or equal to 38 x 33 mm) received 1 session of f-TUL with partial fragmentation; then 3 were sent to an ESWL clinic with good results, while the other patient received 2 more sessions of f-TUL and formed a stone street. Attempts were subsequently made to destroy the latter by ESWL but were unsuccessful. In conclusion, f-TUL appears to be most suitable for smaller impacted ureteral calculi above the pelvic brim.
Kitamura
T
T
Department of Urology, Branch Hospital, Faculty of Medicine, University of Tokyo.
Murahashi
I
I
D000328:Adult; D000368:Aged; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007669:Kidney Calculi / Q000473:pathology / Q000628:therapy*; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D014514:Ureteral Calculi / Q000473:pathology / Q000628:therapy*