Treatment of ureteral calculi with ballistic lithotripsy.
OBJECTIVE
Ballistic lithotripsy is one of the new intracorporeal lithotripsy methods. In this study, the efficacy and complications of this method in the management of ureteral calculi were evaluated.


METHODS
From November 1999 to December 2001, 340 patients (mean age 39.8 years; range 1.5-82 years) with a total of 362 ureteral calculi (bilateral in 22 cases) were treated with an 8.5F rigid ureteroscope and the Swiss Lithoclast. Of the calculi, 115 (32%) were located in the upper ureter, 63 (17%) in the middle ureter, and 184 (51%) in the lower ureter. The mean stone size was 10.4 mm (range 5-22 mm).


RESULTS
Nearly all (344; 95%) of the calculi were accessible with the ureteroscope, and 321 calculi (88.7%) were fragmented completely, either with no residual fragments or with residual fragments <3 mm. In 3 cases (0.8%), there were residual fragments of about 4 mm after the procedure that passed spontaneously. Twenty calculi (5.5%) migrated to the kidney during the procedure and were subsequently treated with adjuvant SWL. Major complications occurred in 2 cases (0.54%): ureteral perforation and stenosis in 1 patient each. The 2-week stone-free rate was 89.5% (324/362).


CONCLUSIONS
Lithoclast ballistic lithotripsy is a safe and effective approach for the treatment of ureteral calculi regardless of composition.
Aghamir
Seyed Kazem
SK
Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Hassan Abad Square, Hafez Street, Tehran, Iran. a-ardesta@Yahoo.com
Mohseni
Mohammad Ghasem
MG
Ardestani
Arash
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005336:Fiber Optic Technology; D005500:Follow-Up Studies; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000175:diagnosis* / Q000628:therapy*; D018666:Ureteroscopy / Q000379:methods