Lechevallier E, Saussine C, Traxer O
Service d'urologie, hôpital La-Conception, 147, boulevard Baille, 13005 Marseille, France.
Prog Urol. 2008 Dec;18(12):912-6. doi: 10.1016/j.purol.2008.09.022. Epub 2008 Oct 16.
Indication for ureteroscopy of an upper urinary tract stone depends on the location and size of the stone. For small proximal ureteral stones, first-line treatment is extracorporeal lithotripsy (ESWL). For big or distal ureteral stones, ureteroscopy (URS) is the more efficient urological treatment. URS has a higher morbidity than ESWL. URS must be careful, urines must be sterile, and a renal safety wire is mandatory. Ideal intracorporeal lithotripsy means are ballistic energy or holmium laser. Ureteral drainage is not always needed in case of easy monobloc removal of a small non impacted stone. In other cases an ureteral drainage is safer. The Stone Free rate of URS is 65-90%. The risk of ureteral stenosis is 1%.
上尿路结石输尿管镜检查的适应证取决于结石的位置和大小。对于近端输尿管小结石,一线治疗是体外冲击波碎石术(ESWL)。对于较大或远端输尿管结石,输尿管镜检查(URS)是更有效的泌尿外科治疗方法。URS的发病率高于ESWL。URS操作必须谨慎,尿液必须无菌,并且必须放置肾安全导丝。理想的体内碎石方法是弹道能量或钬激光。如果小的未嵌顿结石易于整块取出,则不一定需要输尿管引流。在其他情况下,输尿管引流更安全。URS的结石清除率为65%-90%。输尿管狭窄的风险为1%。