Department of Urology, Ludwig-Maximilians-University, Klinikum Grosshadern, Munich, Germany.
Eur Urol. 2012 Apr;61(4):764-72. doi: 10.1016/j.eururo.2012.01.009. Epub 2012 Jan 14.
Ureteral calculi represent a common condition that urologists encounter in everyday practice. Several treatment options are available for calculi that do not pass spontaneously or are unlikely to do so.
In this nonsystematic review, we summarize the existing data on contemporary management of ureteral stones focusing on medical expulsive therapy (MET) and different treatment modalities.
A PubMed search was performed. We reviewed the recent literature on the management of ureteral calculi. Articles were considered between 1997 and 2011. Older studies were included selectively if historically relevant.
For stones that do not pass spontaneously or with MET, shock wave lithotripsy (SWL) and ureteroscopy (URS) are the most common and efficient treatment modalities. Both techniques have obvious advantages and disadvantages as well as different patterns of complications. For select cases or patients, other modalities may be useful.
Ureteral stones of up to 10mm and eligible for observation may be offered MET. For most ureteral calculi that require treatment, advances in SWL and URS allow urologists to take a minimally invasive approach. Other more invasive treatments are reserved for select "nonstandard" cases.
输尿管结石是泌尿科医生在日常实践中常见的病症。对于不能自行排出或不太可能自行排出的结石，有多种治疗方法可供选择。
在本次非系统性综述中，我们总结了目前关于输尿管结石处理的现有数据，重点介绍了医学排石疗法（MET）和不同的治疗方法。
进行了 PubMed 检索。我们回顾了近期关于输尿管结石处理的文献。研究时间为 1997 年至 2011 年。如果在历史上具有重要意义，则选择性地纳入较旧的研究。
对于不能自行排出或经 MET 治疗后仍未排出的结石，体外冲击波碎石术（SWL）和输尿管镜检查术（URS）是最常见和有效的治疗方法。这两种技术都有明显的优点和缺点，也有不同的并发症模式。对于某些特定的病例或患者，其他方法可能会有用。
对于直径不超过 10mm 且适合观察的结石，可以采用 MET 治疗。对于大多数需要治疗的输尿管结石，SWL 和 URS 的进步使泌尿科医生能够采取微创方法。其他更具侵袭性的治疗方法则保留给特定的“非标准”病例。
