Retrograde manipulation for proximal ureteric stones before extracorporeal shockwave lithotripsy: technique, observations and results.
OBJECTIVE
To determine the factors affecting the success of retrograde manipulation (RM) of upper ureteric stones.


METHODS
A total of 601 patients with upper ureteric calculi underwent attempted RM. In 216 patients, RM was performed irrespective of the respiratory phase, stone characteristics and ureteric anatomy (group 1). In the remaining 385 patients RM was performed at the height of expiration (group 2). Patients with large or impacted stones, ureters with a fusiform or funnel shape appearance on urography and grade IV hydronephrosis were not included in group 2.


RESULTS
The success rate was significantly greater in group 2. The rates of fever and perforation in groups 1 and 2 were 6.9/2.3% and 3.2/0.2% respectively. The incidence of residual fragments was also less in group 2.


CONCLUSIONS
RM at the height of expiration is associated with a higher success rate and lower complication rate.
Biyani
C S
CS
RG Stone Clinic, Urological Research Institute, New Delhi, India.
Bhatia
V
V
D006801:Humans; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000628:therapy; D007682:Kidney Pelvis; D008096:Lithotripsy; D011859:Radiography; D007507:Therapeutic Irrigation / Q000379:methods; D013997:Time Factors; D014513:Ureter / Q000473:pathology; D014514:Ureteral Calculi / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*