Demirbas Murat, Samli Murat, Karalar Mustafa, Kose Ahmet C
Private Medicabil Hospital, Bursa, Turkey.
Urol J. 2012 Summer;9(3):557-61.
To retrospectively analyze the efficacy of extracorporeal shockwave lithotripsy (SWL) for managing ureteral stones in patients who were treated during a 12-year period at a single center in Turkey.
The study involved 3300 patients who had single ureteral stone and underwent SWL between January 1999 and March 2011. Medical records from 2836 (85%) patients were available for evaluation. Only patients with radiopaque stones of 5- to 15-mm diameter were included. All procedures were carried out by an experienced urologist (ACK). Patients with proximal ureteral calculi were treated in supine position. Those with mid or distal ureteral stones were treated in modified prone position. Persistence of radiologic image of the stone after three SWL sessions or no spontaneous passage of stone fragments after one month of follow-up was defined as treatment failure. Treatment success was defined as radiologically confirmed fragmentation and spontaneous passage of the stone.
The success rates for the subgroups with stones located in the proximal, mid, and distal ureter were 85.1%, 83.9%, and 88.4%, respectively (P = .257). The success rates for individuals with smaller stones (≤ 10 mm) in the proximal, mid, and distal ureter were 90%, 85.8%, and 90.4%, respectively (P = .07). The corresponding rates for individuals with larger stones (> 10 mm) were 75.3%, 81.3%, and 81.6%, respectively (P = .09).
Our retrospective evaluation of this large patient series reveals that SWL is effective for treating stones in the proximal, mid, and distal ureter.
回顾性分析在土耳其某单一中心接受治疗的患者中，体外冲击波碎石术（SWL）治疗输尿管结石的疗效。
本研究纳入了1999年1月至2011年3月期间3300例患有单一输尿管结石并接受SWL治疗的患者。其中2836例（85%）患者的病历可供评估。仅纳入直径为5至15毫米的不透射线结石患者。所有手术均由经验丰富的泌尿科医生（ACK）进行。近端输尿管结石患者采用仰卧位治疗。中下段输尿管结石患者采用改良俯卧位治疗。三次SWL治疗后结石的放射影像持续存在或随访1个月后结石碎片未自发排出定义为治疗失败。治疗成功定义为经放射学证实结石碎裂并自发排出。
结石位于近端、中段和远端输尿管的亚组成功率分别为85.1%、83.9%和88.4%（P = 0.257）。近端、中段和远端输尿管中较小结石（≤10毫米）患者的成功率分别为90%、85.8%和90.4%（P = 0.07）。较大结石（>10毫米）患者的相应成功率分别为75.3%、81.3%和81.6%（P = 0.09）。
我们对这个大型患者系列的回顾性评估表明，SWL对治疗近端、中段和远端输尿管结石有效。
