The effects of primary in situ extracorporeal shock wave lithotripsy of upper ureteral stones : Need to be push back into kidney before ESWL

Lee, Ja Hun; Lee, Choong Hyun; Chai, Soo Eung

Abstract

The current practice for the management of upper ureteral stones is to push the stone back into the renal pelvis before extracorporeal shock wave lithotripsy. But recent treatment modality for urinary stone is required to be less invasive and morbid. We evaluated 194 patients with upper ureter stones for the effectiveness or push-back. When in situ treatment was performed in 122 patients, the stone free rate at 3 months was 83.6% and the storage for complete fragmentation was 153.5. Push back was tried in 72 patients randomly. Out of them, 13 cases(18.6 %) were manupulated into the renal pelvis successfully and operation was required in 2 cases due to ureteral perforation. The stone free rate was 79.6% and storage for complete fragmentation was 153.7 in push back success group. There was no significant difference between two groups. We think that the primary treatment of choice for upper urinary stone is in situ ESWL. The treatment modality of push back is secondary choice in the case that was railed by primary in situ ESWL.