Percutaneous Treatment of Ureteral Stones

Oscar Schatloff*, Amir Cooper, Yoram I. Siegel

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

Abstract

Percutaneous antegrade ureteroscopy is an effective treatment modality for ureteral stones, particularly when shockwave lithotripsy and retrograde ureteroscopy are presumed to have low success rates or to present increased complications. Indications for an antegrade approach include the presence of large stones with proximal hydroureteronephrosis, concomitant ureteral and renal stones, stone impaction, distal ureteric stricture, urinary diversion, nonrefluxing ureteroneocystostomy, and special anatomic considerations. Preoperative evaluation focuses on burden of stone disease, anatomy of the upper tract, and general patient status. Entrance through an upper or mid-upper calyx is preferred and a flexible nephroscope or ureteroscope is used to access the ureter and stone. The stone can be fragmented or extracted intact with the aid of a basket, as in most instances the upper ureter is fairly dilated. Studies show single-procedure stone-free rates to range from 86% to 100%. Follow-up is necessary for early detection of potential postoperative ureteral strictures.

Original languageEnglish
Title of host publicationSmith's Textbook of Endourology
Subtitle of host publication3rd Edition
PublisherWiley-Blackwell
Pages253-259
Number of pages7
Volume1
ISBN (Print)1444335545, 9781444335545
DOIs
StatePublished - 5 Jan 2012

Keywords

  • Laser lithotripsy
  • Nephrostomy
  • Percutaneous nephrostolithotripsy
  • Shockwave lithotripsy failure
  • Upper ureteral obstruction
  • Ureterolithiasis
  • Ureterolithotripsy

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