Management of ureteral stones with pneumatic lithotripsy: report of 500 patients.
OBJECTIVE
To evaluate the results of pneumatic lithotripsy (PL) with ureteroscopy in the treatment of ureteral stones.


METHODS
We reviewed, retrospectively, the records of 500 patients (366 male, 134 female) with ureteral calculi treated by PL with the Swiss Lithoclast. Of these patients, 124 (24.8%) were treated primarily and 376 (75.2%) were treated secondarily after unsuccessful extracorporeal shockwave lithotripsy (SWL). The results were evaluated 3 months after treatment by excretory urography, ultrasonography, or both.


RESULTS
The over-all stone-free and fragmentation rates were 94.6% and 96.8%, respectively. These values were 97.1% and 98.5% for stones <or=10 mm and 83.7% and 89.1% for stones >10 mm, respectively. The main complications were stone migration (2.0%), urosepsis (3.0%), and ureteral perforation (1.4%).


CONCLUSIONS
While SWL is generally excepted as a first-line treatment option in ureteral stones because of its noninvasive nature, in situ lithotripsy, and especially PL, has higher success rates with minimal morbidity. Thus, PL seems to be a good alternative in patients in whom SWL was unsuccessful or not indicated and in patients who need early stone removal.
Sözen
Sinan
S
Department of Urology, Gazi University School of Medicine, Ankara, Turkey.
Küpeli
Bora
B
Tunc
Lütfi
L
Senocak
Cağri
C
Alkibay
Turgut
T
Karaoğlan
Ustünol
U
Bozkirli
Ibrahim
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D005260:Female; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014514:Ureteral Calculi / Q000628:therapy*