Utility of the lithoclast in the treatment of upper, middle and lower ureteric calculi.

OBJECTIVE

The aim of this study was to evaluate the utility and efficacy of lithoclast in the treatment of upper, middle and lower ureteric calculi.

PATIENTS AND METHODS

Over a period of 6 1/2 years, we have treated 529 ureteric stones which failed to pass spontaneously within a 2-week period. Patients were evaluated for number, site, size and laterality of stones. Patients with ureteroscopy failure were excluded from the study. Once the stone(s) was (were) localised with the ureteroscope, it (they) was (were) treated with the Swiss lithoclast.

RESULTS

Complete fragmentation was achieved in 99% of cases with lower, 97% with mid and 71% with upper ureteric calculi, respectively. The lithotripsy time was only 8.6 minutes for stones < or =1 cm and 14.8 minutes for stones ranging from 1.1 to 2.0 cm. Completely fragmented stones cleared spontaneously within two weeks in 98% of cases and all patients were free of calculi one month after the procedure. Retreatment with the lithoclast was required in six patients for large residual fragments. The mean hospital stay was 1.2 days. Complications were encountered in 6.8% of cases and were managed conservatively.

CONCLUSIONS

Pneumatic lithotripsy is an excellent form of treatment for lower and mid-ureteric calculi. It is a very reliable, highly effective, rapid and safe procedure.