Bhanot Radhika, Jones Patrick, Somani Bhaskar
Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK.
Department of Urology, Haukeland University Hospital, Bergen, Norway.
Res Rep Urol. 2021 May 6;13:227-236. doi: 10.2147/RRU.S311010. eCollection 2021.
The landscape of managing ureteric stones has evolved over the last few decades and several treatment options exist depending on the stone size, location, and other patient and stone factors. While open surgery is now rarely performed, the use of medical expulsive therapy (MET) has been controversial and perhaps only recommended for large distal ureteric stones. The mainstay treatment balances between shockwave lithotripsy (SWL) and ureteroscopy (URS), with the latter usually recommended for larger stones. While the principles of ureteric stone management have remained largely unchanged, the modern era has generated new methods and means to deliver it. Advancements have occurred in all domains of endourology to try and refine treatment and balance it with cost, patient choice and quality of life. Dissemination of technologies and demonstration of their efficacy and safety will eventually result in new recommendations among international guidelines and evolution of new gold standards.
在过去几十年里,输尿管结石的治疗格局不断演变,根据结石大小、位置以及其他患者和结石相关因素,存在多种治疗选择。虽然现在很少进行开放手术,但药物排石疗法(MET)的应用一直存在争议,可能仅推荐用于较大的远端输尿管结石。主要治疗方法在冲击波碎石术(SWL)和输尿管镜检查(URS)之间权衡,后者通常推荐用于较大结石。虽然输尿管结石的治疗原则基本未变,但现代已产生了新的方法和手段来实施治疗。腔内泌尿外科的各个领域都有进展,旨在优化治疗并在成本、患者选择和生活质量之间取得平衡。技术的传播及其疗效和安全性的证明最终将导致国际指南提出新的建议,并催生新的金标准。