Outcome of ESWL in Upper Ureteric Stone with Proximal Hydronephrosis

Abstract

SUMMARY A number of clinical studies performed over the last 15 years have attempted to define the optimal therapeutic approach for upper ureteric stones causing hydronephrosis The introduction of ESWL in 1980s revolutionized the management of upper urinary tract stones, in a few years it gained confidence of the most urologists, and so it became the first line of treatment of upper urinary tract stones. Urinary obstruction is a serious problem, because it can lead to progressive kidney dysfunction or severe complications. In situ SWL, because it is a noninvasive procedure and can be performed without anesthesia, is an attractive line of treatment for obstructing ureteral stones. However, the relation between stone-induced urinary obstruction and SWL outcome in patients with ureteral calculi is still being debated. In our study, 30 patients with solitary, radio-opaque impacted upper ureteral stones 2cm or less were prospectively divided into 3 equal groups,Pts with mild hydronephrosis (Group 1), moderate hydronephrosis group (Group 2) and (Group 3) severe hydronephrosis who were treated by in situ ESWL. Overall success rate was found to be 86.6 % In Patients with mild backpressure was 90%, Patients with Moderate BP was 90%, Patients with Severe BP was 80% The results of this study have demonstrated that the degree of hydronephrosis did not significantly affect the success of SWL in the treatment of solitary proximal ureteral stones 20 mm or less in length.