Efficacy of the Stone Cone for Treatment of Proximal Ureteral Stones: an Initial Clinical Experience / 대한비뇨기과학회지

PURPOSE: Due to the recent trend of performing ureteroscopic removal of stone (URS) for treating upper ureter stones, stone migration into renal pelvis and calices has increased the morbidity and the need for auxillary procedures. The Stone Cone is a device that prevents stone migration during URS. We report here our initial experience of using the Stone Cone during the treatment of upper ureteral stones. MATERIALS AND METHODS: From February 2005 till May 2005, we treated fifteen consecutive patients who were suffering with upper ureteral stones by using the Stone Cone and performing semi-rigid ureteroscopy and pneumatic lithoclast. Pneumatic lithotripsy was done in 11 patients and the remaining 4 cases were treated by using a stone basket and forceps. RESULTS: The Stone Cone was successfully placed in all 15 cases. In 13 patients, it was placed via cystoscopy under fluroscopic guidance, while 2 patients with 2 impacted stones required ureteroscopic placement. No patients had residual fragments greater than 3mm and they didn't require auxiliary procedures. CONCLUSIONS: The Stone Cone is a new device that prevents stone migration and allows safe extraction of fragments during URS. This study shows that the success rate of URS for proximal ureteral stones was 100% with using the Stone Cone.

The Varying Success of Ureteroscopic Removal of Stone (URS) in Relation to the Different Locations and Sizes of Upper Ureter Stones / 대한비뇨기과학회지

PURPOSE: There has been a recent trend of using ureteroscopic removal of stone (URS) for treating upper ureter stones, due to its safety and success rate; therefore we attempted to find the varying success of URS for different locations and sizes of upper ureter stone. MATERIALS AND METHODS: 107 patients with upper ureter stones, who were treated with URS in our hospital, between January 2000 and May 2005, were retrospectively reviewed. The patients were classified into three groups according to the locations (named L3, L4 and L5) and sizes ( or=10mm) of the upper ureter stones. RESULTS: The overall success rate of URS was 71.0%. With regard to the three locations, L3 had a 46.3% success rate, while L4 and L5 had success rates of 76.9 and 92.5%, respectively. The success rates of URS were significantly higher in L4 and L5 locations compared with that in L3 (p<0.05). In addition, the success rates of URS for stones equal to or larger than 10mm and less than 10mm were 59.5 and 78.5%, respectively, with the former being significantly lower than the latter (p=0.036). CONCLUSIONS: The success rates of URS were significantly higher when the location of upper ureter stones was lower than L4 and when the size of the stone was less than 10mm. Therefore, both the location and size of the stones are important factors potentially influencing the outcome of URS for upper ureter stones.