THE MANA6£M£NT' OF URETERAL <CAL.CUU BY EXTRACORPOREAL SHOCK WAV£ UTHOTRIPSY- V£JRSUS UR£T£ROSCOP1(: A COMPAR\1\TIV£ STUDY

Abstract

Ureteroscopy represents a significant advance in the diagnosis and treatment of ureteral lesions. • It allows for direct visualization of the ureter and much of the intrarenal collecting system. Biopsies can be performed under direct vision and with great accuracy. Ureteroscopy makes it possible to engage stones in a basket or to disintegrate larger stones using ultrasound or electrohydraulic lithotripsy under direct vision and with great safety.

The presented work was carried out Between January, 1994 and April, 1996, on 200 patients with ureteric stones. They were subjected either to ureteroscopy using the standard technique or ESWL using Siemens lithostar lithotriptor. This work was done at the department of Urology I Menoufia University Hospital ar:d El-Kateb Hospital.

In this study we started by reviewing most of the literatures written on ureteroscopy and ESWL in treating ureteric stones.

The total number of cases for whom ureteroscopy was carried out to extract ureteral calculi IS one hundred case (79 patients with pelvic ureteral stones and 21 patients with iliac ureteral stones). The over-all success rate Is 94% In this study, successful basket extraction was achieved m 84.8% of patients. US. disintigration was. carried out successfully m only one patient (1.3%). The foreceps extraction was performed successfully m (10.1%). All of the previous results were obtained in the patients of the pelvic devision of the ureteroscopy group. In the iliac devision of the ureteroscpy group, successful basket extraction was achieved m (76%) while, successful forceps extraction was done in (9.5%). It is observed that success rate is quite highr in the lower third (96.2%) than in middle thirds (95.2%).