Ureteroscopic Lithotripsy with Pneumatic Lithotriptor: 274 Cases / 대한비뇨기과학회지

ABSTRACT

PURPOSE: We retrospectively reviewed cases of ureteroscopic lithotripsy where a pneumatic lithotriptor had been used, and report on the success and complications related to this procedure. MATERIALS AND METHODS: Between October 1996 and September 2005, ureteroscopic lithotripsy was performed in 319 cases. The medical records of 274 of these cases were available for review. The ureteroscopic lithotripsy had been performed using a rigid ureteroscope (Stortz, 10Fr) and pneumatic lithotriptor (Swiss lithoclast). A successful procedure was defined as the absence of a residual stone larger than 2mm in size on postoperative KUB or ultrasonography. RESULTS: 53, 32 and 189 stones were located in the upper, middle and lower ureter, which were defined as groups 1, 2 and 3, respectively. The overall success rate was 92.7%. The success rates of upper, middle and lower ureteral stones were 77.4 (41/53), 93.8 (30/32) and 96.8% (183/189), respectively. The success rate in group 1 was significantly lower than the other two groups (p<0.05). The most common cause of failure was the upward migration of the stone. The rates of stent indwelling were 37.7 (20/53), 34.5 (11/32) and 32.8% (62/189) in groups 1, 2 and 3, respectively. Perforation rates were 5.7 (3/53), 3.1 (1/32) and 2.1% (4/189) in groups 1, 2 and 3, respectively. All patients with a ureteral perforation were successfully treated with a double-J stent indwelling only for a period of 4-6 weeks. The most common complications were pain and gross hematuria. CONCLUSIONS: Ureteroscopic lithotripsy, with a pneumatic lithotriptor, is an effective and safe primary treatment modality for both middle and lower ureteral stones.