MANAGEMENT OF THE IMPACTED URETERAL CALCULUS

被引:114
|
作者
MORGENTALER, A [1 ]
BRIDGE, SS [1 ]
DRETLER, SP [1 ]
机构
[1] HARVARD UNIV,MASSACHUSETTS GEN HOSP,SCH MED,DEPT UROL,FRUIT ST,BOSTON,MA 02114
来源
JOURNAL OF UROLOGY | 1990年 / 143卷 / 02期
关键词
D O I
10.1016/S0022-5347(17)39928-7
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
The management of 42 impacted ureteral calculi is reviewed. Impacted stones were defined by the inability to pass a guide wire or catheter on initial attempts. Stones were impacted in the upper ureter in 10 patients, mid ureter in 11 and lower ureter in 21. Upper ureteral stones were treated in 8 patients by extracorporeal shock wave lithotripsy after disimpaction by laser or other techniques. Mid ureteral stones were treated by laser alone in 7 patients and by extracorporeal shock wave lithotripsy after disimpaction in 4. Lower stones were treated by laser in 17 patients and ultrasound in 2. Complications included 3 major and 5 minor perforations, and 4 false passages. Treatment was successful without an open operation in 40 of 42 patients (95%). Our current approach to impacted ureteral calculi involves passing a rigid ureteroscope to the stone, with disimpaction performed by laser fragmentation or other dislodgement maneuvers. Proximal stones or large fragments then are treated by extracorporeal shock wave lithotripsy. Mid ureteral stones are treated similarly, unless they are so fragile that in situ fragmentation may be completed easily. Lower ureteral stones are fragmented in situ, with hard fragments extracted by basket. Alternative treatments for impacted calculi at all levels include unstented in situ extracorporeal shock wave lithotripsy, antegrade ureteroscopy and, finally, an operation.
引用
收藏
页码:263 / 266
页数:4
相关论文
共 50 条
  • [1] Impacted ureteral calculus
    Cooper, JWA
    [J]. BRITISH MEDICAL JOURNAL, 1937, 1937 : 354 - 354
  • [2] Primary carcinoma of the kidney with impacted ureteral calculus
    Bugbee, HG
    [J]. JOURNAL OF UROLOGY, 1921, 5 (04): : 267 - 278
  • [3] Bilateral urinoma due to an unilateral impacted ureteral calculus
    Katumalla, F. S.
    Lambe, S.
    Jariwala, S. K.
    Mammen, K. J.
    [J]. INDIAN JOURNAL OF UROLOGY, 2006, 22 (04) : 374 - 375
  • [4] New technique of ureteral stent placement for impacted ureteral calculus: The glidewire loop technique
    Issa, MM
    Pruthi, RS
    McNamara, DE
    [J]. UROLOGY, 1997, 49 (04) : 614 - 617
  • [5] CHANGING CONCEPTS IN THE MANAGEMENT OF URETERAL CALCULUS
    SUAREZ, GM
    THOMAS, R
    [J]. JOURNAL OF UROLOGY, 1987, 137 (04): : A299 - A299
  • [6] ENDOSCOPIC MANAGEMENT OF IMPACTED URETERAL STONES - RISKS AND RESULTS
    Lux, C.
    Schwab, S.
    Frimberger, M.
    Gschwend, J.
    Straub, M.
    [J]. JOURNAL OF ENDOUROLOGY, 2010, 24 : A221 - A222
  • [7] Management and follow-up of impacted ureteral stones
    Deliveliotis, C
    Chrisofos, M
    Albanis, S
    Serafetinides, E
    Varkarakis, J
    Protogerou, V
    [J]. UROLOGIA INTERNATIONALIS, 2003, 70 (04) : 269 - 272
  • [8] Management of encrusted ureteral stents impacted in upper tract
    Bultitude, MF
    Tiptaft, RC
    Glass, JM
    Dasgupta, P
    [J]. UROLOGY, 2003, 62 (04) : 622 - 626
  • [9] Antegrade ureteroscopy for impacted lower ureteral calculus: A salvage procedure for failed retrograde ureteroscopy
    Monish Aron
    Anup Kumar
    Pankaj Wadhwa
    [J]. International Urology and Nephrology, 2004, 36 (Suppl 1) : 6 - 8
  • [10] Ureteral calculus
    Smith, GG
    [J]. BOSTON MEDICAL AND SURGICAL JOURNAL, 1924, 191 : 435 - 437