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Extracorporeal Lithotripsy of Ureteric Calculi Using the Dornier HM‐3 Lithotriptor
Author(s) -
BENIZRI E.,
AUGUSTI M.,
AZOULAI G.,
CHARBIT L.,
CUKIER J.
Publication year - 1992
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1992.tb15827.x
Subject(s) - medicine , ureteroscopy , ureter , extracorporeal shock wave lithotripsy , surgery , lithotripsy , renal pelvis , pelvis
Summary Over a 5‐year period (November 1984 November 1989), we treated 356 patients with ureteric calculi; 170 were treated by extracorporeal shock wave lithotripsy (ESWL) on a Dornier HM‐3 lithotriptor. The calculi (n = 176) were uniformly distributed along the length of the ureter: 44 were just below the periureteric junction, 59 were lumbo‐iliac, 42 were in the upper bony pelvis and 32 in the lower bony pelvis. The mean diameter of the upper ureteric calculi was 10 mm and for the others it was 8 mm. Thirty‐four patients with acute obstructive pyelonephritis required pre‐ESWL drainage of the urine. X‐ray localisation required intraveneous urography during lithotripsy in 52 cases (30%). On plain X‐ray the following day 170 stones (96%) were judged to have disintegrated. The 6 patients whose stones were not fragmented received further treatment (ureterotomy (4) and ureteroscopy (2)). Five patients required additional treatment because of pain or fever (catheterisation (3) and ureterotomy (2)) and 2 patients had a second lithotripsy owing to insufficient fragmentation. Four patients were lost to follow‐up. In 153 patients (90%) the fragments were eliminated completely, 146 in the first month and the remainder before the sixth month. No serious sequelae were observed. In addition to the 5 patients who required supplementary treatment. 11 patients with pain or fever needed medical treatment. We recommend first intention in situ ESWL for all ureteric calculi.