[Extracorporeal lithotripsy in the treatment of upper urinary tract lithiasis].
The advent of extra-corporal shock-wave lithotripsy in the eighties totally changed management strategies for renal and ureteral lithiasis of the upper urinary tract. Currently, approximately 80% of all patients can benefit from lithotripsy with an overall success rate of about 75%. Although classical surgery has a higher success rate of about 90%, extra-corporal shock-wave lithotripsy has many advantages. First there is a very low risk of morbidity (pain, immobilization, complications) for this outpatient treatment. Second, the overall cost, including that of preventive treatment, is low as illustrated by the major reduction in the number of cases of pyonephritis on stones and of corraliform lithiasis. The apparent safety of shock-wave therapy should not mask the risk of unacceptable indications: small stones which may resolve spontaneously or inversely very large stones carrying the risk of residual fragments and renal damage. Long-term morbidity remains to be evaluated, but the management of upper urinary tract lithiasis now relies heavily on shock-wave therapy alongside conventional surgery and percutaneous or endoscopic methods.
Département d'Urologie, Centre Médico-Chirurgical de la Porte de Choisy, Paris.
B
B
Guillonneau
O
O
Wetzel
B
B
Veillon
F
F
Cour
L
L
Cohen
N
N
Abadie
G
G
Vallancien
D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy / Q000009:adverse effects; D008297:Male; D012307:Risk Factors; D014514:Ureteral Calculi / Q000628:therapy*
La lithotritie extracorporelle dans le traitement de la lithiase du haut appareil urinaire.