Clinical Experience of In Situ Extracorporeal Shock Wave Lithotripsy for Ureteral Stones

Kang, Sung Hak; Hwang, Jua Cheol; Cho, Dae Haeng

Abstract

We reviewed our experience of in situ extracorporeal shock wave lithotripsy(ESWL) for primary ureteral stones in 284 patients between March 1994 and October 1995. The second-generation lithotripter, Direx Compact, was used for stone disintegration without any manipulation of stone and only parenteral analgesics were used for pain control during ESWL. The locations of stones were upper in 140(49.3%), mid in 39(13.8%) and lower ureter in 105(36.9%) cases. Of the 284 patients, 250(88.0%) were stone free and 5(1.7%) had some residual stones, while 29(10.2%) patients were failed to respond to the treatment. The stone size was significant factor influencing the final result. Re-ESWL was necessary in 48 patients(16.9%) and auxillary procedures including percutaneous nephrostomy and double-J catheterization were required in 18 patients(6.3%). The over all efficiency quotient was 71.4. The 29 patients who were refractory to in situ ESWL were managed by ureteroscopic manipulation(10 cases) or open surgery(19 cases). The complications were mild but admission was required in 8 patients(2.8%) with colic pain or fever. Our experience shows that in situ ESWL is a noninvasive and efficient method to treat ureteral stones within whole length of ureter.