Minimally invasive approaches to upper urinary tract urolithiasis.
The surgical management of urolithiasis is an ever-changing discipline that presents unique challenges to the urologist. This article reviews the current minimally invasive treatment options for upper urinary tract urolithiasis. First it examines several factors that influence stone-free rates, including Hounsfield units of calculi, obesity, and lower pole factors. Surgical management of ureteral calculi is reviewed along with a discussion of stone management in high-risk patients including those who are pregnant. Surgical technique of shockwave lithotripsy, ureteroscopy, percutaneous nephrolithotomy, and laparoscopy is discussed in depth, with attention paid to possible variations in technique.
Wignall
Geoffrey R
GR
Division of Urology, University of Western Ontario, 268 Grosvenor Street, London, Ontario, Canada N6A 4V2.
Canales
Benjamin K
BK
Denstedt
John D
JD
Monga
Manoj
M