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EVALUATION OF URS TREATMENT OF URETERAL STONES POST UNSUCCESSFUL ESWL
Article published in Urologia Polska 1998/51/2.

authors

Tomasz Borkowski, Roman Sosnowski, Leszek Bęc, Janusz Judycki, Andrzej Borkowski
Katedra i Klinika Urologii AM w Warszawie
Kierownik Kliniki: prof. A. Borkowski

keywords

ureter ureteral stones state post ESWL URS

summary

Objective. ESWL, the least invasive method of fragmenting ureteral calculi,
is the treatment of choice and URS techni±ue are rather used when ESWL
fails. The authors try to answer the question if there are predicting factors
which can influence the positive outcome of URS treatment in patients after
unsuccessful fragmentation of calculi by ESWL.
Patients and method. In the years 1993-1995 we performed ureterore-
noscopy in 181 ureters in 173 patients, in whom we did not managed to
disintegrate calculi after single or multiple ESWL. 85 male and 88 female 7
to 83 years old underwent 197 URS procedures (14 patients were treated
more than once). The number of ESWL Sessions, duration of disease, local-
ization and number of calculi, time of URS procedure and hospitalization
stay, JJ stent placement, radiological and microbiological findings were evalu-
ated.
Results. In 31 patient (17.1%) calculi were extracted in one piece, in 68
37.5%) in fragments and in 19 (10.5%
gration. In 54 cases (29.8%) the calculus was pushed up to the kidney collecting
system, 9 times (5%) we could not reach the stone because of stricture. The
average time of URS in upper middle and lower parts of ureter were
correspondingly 52, 73, 62 min. Complication occurred in 16.4% of uretero-
scopies but only two patients had to be treated with open surgery.
Conclusion. In the cases when ESWL treatment fails URS is efficient and
quite safe procedure. Localization of calculi occurred to be the only factor
related to results.

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