上部尿管結石に対するESWLとTULの治療成績

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  • ジョウブ ニョウカン ケッセキ ニ タイスル ESWL ト TUL ノ チリョウ セイセキ

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Abstract

We retrospectively compared the success rates of extracorporeal shock wave lithotripsy(ESWL)and transurethral lithotripsy(TUL). This study evaluated a total of 212 patients with proximal ureteral stones from April 2008 to October 2012. “Stone-free” was defined as when stones were completely removed or the residual fragments were ≦4mm at 3 months after the procedure. The gender, age, BMI, stone size, Hounsfield units(HU), and existence of hydronephrosis before the operation were evaluated to determine the predictive factors for successful treatment. The stone-free rates(SFR)for ESWL and TUL were 70.3% and 90.3%, respectively(p=0.03). SRF in ESWL was considerably low in patients with HU>1000(37.5%), and a high HU value strongly affected the treatment failure(p<0.003). Multivariate analysis of all patients showed that age <65, HU<1000, and TUL were predictive factors for successful treatment. TUL is more effective than ESWL for patients with proximal ureteral stones in this study.

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