Percutaneous nephrostomy for removal of large impacted upper ureteral stones.
The treatment for patients with large impacted proximal ureteral stone remains controversial. Extracorporeal shock wave lithotripsy and ureteroscopic lithotripsy are the most popular treatment options due to their minimal invasive nature. However, percutaneous nephroscopic ureterolithotripsy is still important. Between June 2004 and March 2006, a total of 24 patients under went percutaneous antegrade nephrostomy for the removal of large impacted proximal ureteral stones of size > 15 mm. Combined ultrasonic and pneumatic lithotripters were used for the stone fragmentation. Twenty-three (95.8%) of the 24 patients were stone-free after one session of surgery. The mean operation time was 125.4 +/- 49.5 minutes (range, 45-170 minutes) and the mean postoperative hospital stay was 4.7 +/- 2.0 days (range, 4-12 days). Among the 24 patients, six experienced transient postoperative fever that could be controlled with appropriate antibiotics and supportive treatment, and two had blood loss requiring blood transfusion. We suggest that percutaneous nephroscopic ureterolithotripsy is a safe and efficient treatment option for the removal of large impacted proximal ureteral stones.
Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan.
Yung-Shun
YS
Juan
Ching-Chia
CC
Li
Jung-Tsung
JT
Shen
Chun-Hsiung
CH
Huang
Shu-Mien
SM
Chuang
Chii-Jye
CJ
Wang
Wen-Jeng
WJ
Wu
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000379:methods*; D014514:Ureteral Calculi / Q000601:surgery*