Ureteroscopic lithotripsy using Swiss Lithoclast for the management of ureteral stones: our experience in 200 patients
Syed Abeer Hussain, Nisar A Wani, Baldev Singh, Arif Hameed
2010
Türk Üroloji Dergisi/Turkish Journal of Urology
Objective: To study the efficacy of ureteroscopic management of ureteric calculi using Swiss Lithoclast in a cohort of 200 patients. Materials and methods: The patients were diagnosed of ureteric stone on ultrasonography, radiography, intravenous urography or computed tomography. Ureteroscopic lithotripsy (URSL) was done using 8/9.8 F rigid Olympus ureteroscope and Swiss Lithoclast. Results: Patients aged between 15 to 70 years with 94 males and 106 females. Most common presenting complaint was
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... the pain. Hydroureteronephrosis was seen in 57%. Most patients had stone on right side. Most of the stones were 5-10 mm in size. Majority of the stones treated were from the lower ureter (72.32%). Of the stones, 91.51% were successfully fragmented. D-J stent was used in 40% patients. Operation time was less than an hour in most of the cases. There were minimal severe or long-term effects (stricture, 0.5%). Mean hospital stay was 1.54 days. Only 2% patients had proximal stone/ fragment migration. Overall success rate of the treatment was 90.5%. Conclusion: URSL using Swiss Lithoclast is an effective, cheap and reliable method of ureteric stone management. Besides, lack of any disposable components, extremely long instrument life, and easy maintenance of the Swiss Lithoclast suits well with the needs of low socioeconomic countries like India. Özet Amaç: Üreterik ta lar n Swiss Lithoclast ile yap lan üreteroskopik tedavisinin 200 hastal k kohort üzerinde etkinli inin de erlendirilmesi amaçlanm t r. Gereç ve yöntem: Hastalarda üreterik ta oldu u ultrasonografi, radyografi, intravenöz urografi ya da bilgisayarl tomografi ile belirlenmi tir. Üreteroskopik litotripsi (URSL), 8/9.8 F rijid Olympus üretereskop ve Swiss Lithoclast ile yap lm t r. Bulgular: Hastalar n ya 15 ile 70 aras nda olup, 94'ü erkek ve 106's kad nd . En s k ba vuru ikayeti a r idi. Hastalar n %57'sinde hidroüreteronefroz tespit edildi. Hastalar n ço unda ta sa taraftayd . Ta lar n ço u 5-10 mm ölçülerindeydi. Tedavi edilen ta lar n ço u (%72.32) alt üreter kaynakl yd . Ta lar n %91.51'i ba ar l bir ekilde fragmente edildi. Hastalar n %40' nda D-J stent kullan ld . Hastalar n ço unda operasyon süresi bir saatten k sayd . Minimal düzeyde iddetli ve uzun dönem etki vard (striktür, %0.5). Ortalama hastanede kal süresi 1.54 gündü. Hastalar n sadece %2'sinde proksimal ta /fragment migrasyonu vard . Tedavinin genel ba ar oran %90.5 idi. Sonuç: Üreterik ta tedavisinde Swiss Lithoclast kullanlarak yap lan URSL etkili, ucuz ve güvenli bir yöntemdir. Ayr ca, Swiss Lithoclast' n tek kullan ml k parças n n olmamas , son derece uzun alet ömrü ve kolay bak m , Hindistan gibi dü ük sosyoekonomik artlar olan ülkelerin ihtiyaçlar na uyum sa lamaktad r. Anah tar söz cük ler: Litotripsi; Swiss Lithoclast; ureteral ta .
doi:10.5152/tud.2010.044
fatcat:qjpfklkc2nbcxn4zp2h2tbtk4a