Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie · 2002
[In situ treatment of a series of 1690 ureteral stones by EDAP-LT02 extracorporeal shock-wave lithotripsy].
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Ghaddar Yehia
Аннотация
OBJECTIVE: Efficiency of lithotripsy on ureteral stones treated in situ by EDAP-LT02.
MATERIAL AND METHOD: Between January 1992 and March 2001, 1,690 ureteric stones were treated in situ by extracorporeal shock-wave lithotripsy (ESWL) in 1,480 patients with 1 to 4 stones. This study compared two series: series 1998, comprising 1,013 stones in 859 patients treated between January 1992 and January 1998, and series 2001, comprising 677 stones in 621 patients treated between February 1998 and March 2001. This second series benefited from improvement of the equipment especially the ultrasound apparatus, which improved the mixed detection rate from 36% to 58%. The stone was situated in the lumbar ureter in 48.5% of cases, the iliac ureter in 7.5% of cases and the pelvic ureter in 44% of cases. Stone diameter ranged from 5 mm to 25 mm. Treatment consisted of 1 to 4 sessions. All sessions were performed on an outpatient basis without anaesthesia.
RESULTS: The results were better with mixed detection (p < 0.028). Comparison of the 2 series showed a significant improvement (p < 0.012): the mean number of sessions per patient decreased from 1.47 to 1.21, the mean duration of treatment decreased from 84 min to 74 min, the mean cumulative energy delivered decreased from 86 to 72. The overall success rate (elimination of all fragments) increased from 58% to 85% after the first session, from 83% to 95% after the second session and from 91% to 98% after the third session.
COMPLICATIONS: 0.43% of treated patients developed acute pyelonephritis and 6.1% experienced renal colic. IVU, performed three months after ESWL in patients treated by several sessions, did not reveal any ureteric lesions.
CONCLUSION: ESWL by EDAP-LT02 is a noninvasive outpatient procedure and constitutes the treatment of choice for ureteric stones. It is more effective in combination with mixed detection. The results are improved by several treatment sessions without any adverse effects.
MATERIAL AND METHOD: Between January 1992 and March 2001, 1,690 ureteric stones were treated in situ by extracorporeal shock-wave lithotripsy (ESWL) in 1,480 patients with 1 to 4 stones. This study compared two series: series 1998, comprising 1,013 stones in 859 patients treated between January 1992 and January 1998, and series 2001, comprising 677 stones in 621 patients treated between February 1998 and March 2001. This second series benefited from improvement of the equipment especially the ultrasound apparatus, which improved the mixed detection rate from 36% to 58%. The stone was situated in the lumbar ureter in 48.5% of cases, the iliac ureter in 7.5% of cases and the pelvic ureter in 44% of cases. Stone diameter ranged from 5 mm to 25 mm. Treatment consisted of 1 to 4 sessions. All sessions were performed on an outpatient basis without anaesthesia.
RESULTS: The results were better with mixed detection (p < 0.028). Comparison of the 2 series showed a significant improvement (p < 0.012): the mean number of sessions per patient decreased from 1.47 to 1.21, the mean duration of treatment decreased from 84 min to 74 min, the mean cumulative energy delivered decreased from 86 to 72. The overall success rate (elimination of all fragments) increased from 58% to 85% after the first session, from 83% to 95% after the second session and from 91% to 98% after the third session.
COMPLICATIONS: 0.43% of treated patients developed acute pyelonephritis and 6.1% experienced renal colic. IVU, performed three months after ESWL in patients treated by several sessions, did not reveal any ureteric lesions.
CONCLUSION: ESWL by EDAP-LT02 is a noninvasive outpatient procedure and constitutes the treatment of choice for ureteric stones. It is more effective in combination with mixed detection. The results are improved by several treatment sessions without any adverse effects.