title: Local shock-wave lithotripsy of distal ureteral calculi.
abstract: Since the initiation of the clinical trial utilizing a second-generation lithotripor (Lithostar, Siemens, Erlangen, FRG), 96 patients with distal ureteral calculi (i.e. calculi below the pelvic brim) underwent local shock-wave lithotripsy. Routine treatment was conducted under intravenous sedation and light analgesia only. Complete stone disintegration was achieved in 84 patients (87.5%), 11 requiring two sessions and 1 patient, three. In 7 patients ureteroscopy became necessary after unsuccessful local shock-wave treatment. In 2 of these patients a 9-french flexible ureteroscope and the Storz Q-switched neodymium-YAG laser was used for stone disintegration. In 3 cases loop extraction and in 2 cases open surgery had to be performed for definitive stone removal. All pre- and postoperative manipulations (except open surgery) were done on the Lithostar. Local shock-wave lithotripsy is a highly successful, noninvasive, time-saving and easily applicable technique. It has become our primary approach in the treatment of distal ureteral calculi.
mesh_terms: D002986:Clinical Trials as Topic; D004724:Endoscopy; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D014514:Ureteral Calculi / Q000175:diagnosis / Q000628:therapy*