Cimentepe Ersin, Unsal Ali, Saglam Remzi, Balbay M Derya
Department of Urology, Fatih University School of Medicine, Ciftlik Cd No: 57, 06510 Emek, Ankara, Turkey.
J Endourol. 2003 Dec;17(10):863-5. doi: 10.1089/089277903772036154.
To compare the efficacy of extracorporeal shockwave lithotripsy (SWL) in patients with radiopaque and radiolucent ureteral calculi.
Between September 2001 and August 2002, a total of 113 consecutive patients with ureteral calculi (58 radiopaque [Group 1], 55 radiolucent [Group 2]) were treated with a Multimed 2001 trade mark lithotripter under fluoroscopic monitoring. Localization of radiolucent stones was achieved after a bolus injection of contrast medium 1 mL/kg, the shockwaves being focused just below the end of contrast column. All patients were treated on an outpatient basis under analgesia and light sedation if required. The mean follow-up was 14 (range 6-23) months. Patients were reevaluated by some combination of plain films, ultrasound scanning, and intravenous urography 3 months after the treatment. Groups were compared with ANOVA and Mann-Whitney U tests. A P value <0.05 was regarded as statistically significant.
There were no statistically significant differences in any parameter between groups. At 3 months, the success rate (stone-free status) was 87.9% in Group 1 and 89% in Group 2 (P = 0.848). Double-J catheter replacement was needed for three patients in Group 1 and for two patients in Group 2 (P = 0.693). Two patients from Group 1 and three from Group 2 underwent intracorporeal lithotripsy with ureterorenoscopy (P = 0.606). No adverse reactions to contrast medium occurred in Group 2.
Patients with radiolucent ureteral calculi can be treated efficiently with SWL by contrast medium injection if ultrasonic localization is not possible.
比较体外冲击波碎石术（SWL）治疗不透光和透光输尿管结石患者的疗效。
2001年9月至2002年8月期间，共有113例连续的输尿管结石患者（58例不透光结石[第1组]，55例透光结石[第2组]）在荧光镜监测下使用Multimed 2001商标碎石机进行治疗。在静脉推注1 mL/kg造影剂后实现透光结石的定位，冲击波聚焦在造影剂柱末端下方。所有患者在门诊接受治疗，必要时给予镇痛和轻度镇静。平均随访时间为14（6 - 23）个月。治疗3个月后，通过X线平片、超声扫描和静脉肾盂造影等多种检查方法对患者进行重新评估。采用方差分析和曼-惠特尼U检验对两组进行比较。P值<0.05被视为具有统计学意义。
两组之间在任何参数上均无统计学显著差异。3个月时，第1组的成功率（结石清除状态）为87.9%，第2组为89%（P = 0.848）。第1组有3例患者需要更换双J导管，第2组有2例患者需要更换（P = 0.693）。第1组有2例患者和第2组有3例患者接受了输尿管镜体内碎石术（P = 0.606）。第2组未发生造影剂不良反应。
对于透光输尿管结石患者，如果无法进行超声定位，可通过注射造影剂后采用SWL有效治疗。
