Korean J Urol.  2006 Apr;47(4):412-417. 10.4111/kju.2006.47.4.412.

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

• Chung HS
• Park JY
• Kim HK
• Park CM

• KMID: 1997153
• DOI: http://doi.org/10.4111/kju.2006.47.4.412

Abstract

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.

Keyword

Ureteral calculi; Ureteroscopy; Equipment and supplies; Stone cone

MeSH Terms

Cystoscopy
Equipment and Supplies
Humans
Kidney Pelvis
Lithotripsy
Surgical Instruments
Ureter*
Ureteral Calculi
Ureteroscopy

Figure

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  Fig. 1 Gross and fluroscopic findings of the Stone Cone catheter.

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  Fig. 2 Endoscopic findings of the Stone Cone catheter.

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  Fig. 3 Stone Cone catheter is completely coiled and is holding stone.

Reference

1. Segura JW. The role of percutaneous surgery in renal and ureteral stone removal. J Urol. 1989. 141:780–781.

2. Erhard M, Salwen J, Bagley DH. Ureteroscopic removal of mid and proximal ureteral calculi. J Urol. 1996. 155:38–42.

3. Knispel HH, Klan R, Heicappell R, Miller K. Pneumatic lithotripsy applied through deflected working channel of miniureteroscope: results in 143 patients. J Endourol. 1998. 12:513–515.

4. Robert M, Bennani A, Guiter J, Averous M, Grasset D. Treatment of 150 ureteric calculi with the lithoclast. Eur Urol. 1994. 26:212–215.

5. Holley PG, Sharma SK, Perry KT, Turk TM. Assessment of novel ureteral occlusion device and comparison with stone cone in prevention of stone fragment migration during lithotripsy. J Endourol. 2005. 19:200–203.

6. Chow GK, Patterson DE, Blute ML, Segura JW. Ureteroscopy: effect of technology and technique on clinical practice. J Urol. 2003. 170:99–102.

7. Bagley DH. Removal of upper urinary tract calculi with flexible ureteropyeloscopy. Urology. 1990. 35:412–416.

8. Netto Junior NR, Claro JF, Lemos GC, Cortado PL. Treatment options for ureteral calculi: endourology or extracorporeal shockwave lithotripsy. J Urol. 1991. 146:5–7.

9. Puppo P, Ricciotti G, Bozzo W, Introini C. Primary endoscopic treatment of ureteric calculi. A review of 378 cases. Eur Urol. 1999. 36:48–52.

10. Kim HJ, Kim CS, Ahn HJ, Ahn TY, Kim HK. Ureteroscopic removal of stone: results and complications. Korean J Urol. 1993. 34:123–129.

11. Hollenbeck BK, Schuster TG, Faerber GJ, Wolf JS Jr. Comparison of outcomes of ureteroscopy for ureteral calculi located above and below the pelvic brim. Urology. 2001. 58:351–356.

12. Chung JS, Park RJ. Ureteroscopic management of ureteral calculi: comparisons of stone Basket, electrohydraulic lithotripsy, Swiss lithoclast and holmium: YAG Laser. Korean J Urol. 2000. 41:239–245.

13. Begun FP. Modes of intracorporeal lithotripsy: ultrasound versus electrohydraulic lithotripsy versus laser lithotripsy. Semin Urol. 1994. 12:39–50.

14. Tawfiek ER, Bagley DH. Management of upper urinary tract calculi with ureteroscopic techniques. Urology. 1999. 53:25–31.

15. Lam JS, Greene TD, Gupta M. Treatment of proximal ureteral calculi: holmium:YAG laser ureterolithotripsy versus extracorporeal shock wave lithotripsy. J Urol. 2002. 167:1972–1976.

16. Desai MR, Patel SB, Desai MM, Kukreja R, Sabnis RB, Desai RM, et al. The Dretler stone cone: a device to prevent ureteral stone migration-the initial clinical experience. J Urol. 2002. 167:1985–1988.

17. Maislos SD, Volpe M, Albert PS, Raboy A. Efficacy of the Stone Cone for treatment of proximal ureteral stones. J Endourol. 2004. 18:862–864.

18. Yaycioglu O, Guvel S, Kilinc F, Egilmez T, Ozkardes H. Results with 7.5F versus 10F rigid ureteroscopes in treatment of ureteral calculi. Urology. 2004. 64:643–647.