Bader MJ et al, 2012: Contemporary management of ureteral stones
Bader MJ, Eisner B, Porpiglia F, Preminger GM, Tiselius HG
Department of Urology, Ludwig-Maximilians-University, Klinikum Grosshadern, Munich, Germany
Ureteral calculi represent a common condition that urologists encounter in everyday practice. Several treatment options are available for calculi that do not pass spontaneously or are unlikely to do so.
OBJECTIVE: In this nonsystematic review, we summarize the existing data on contemporary management of ureteral stones focusing on medical expulsive therapy (MET) and different treatment modalities.
EVIDENCE ACQUISITION: A PubMed search was performed. We reviewed the recent literature on the management of ureteral calculi. Articles were considered between 1997 and 2011. Older studies were included selectively if historically relevant.
EVIDENCE SYNTHESIS: For stones that do not pass spontaneously or with MET, shock wave lithotripsy (SWL) and ureteroscopy (URS) are the most common and efficient treatment modalities. Both techniques have obvious advantages and disadvantages as well as different patterns of complications. For select cases or patients, other modalities may be useful.
CONCLUSIONS: Ureteral stones of up to 10mm and eligible for observation may be offered MET. For most ureteral calculi that require treatment, advances in SWL and URS allow urologists to take a minimally invasive approach. Other more invasive treatments are reserved for select "nonstandard" cases.
Copyright Â© 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved
Eur Urol. 2012 Apr;61(4):764-72. doi: 10.1016/j.eururo.2012.01.009. Epub 2012 Jan 14
PMID: 22266271 [PubMed - indexed for MEDLINE]
This look at the latest developments in the treatment of ureteral stones given in this publication shows that the database and conclusions of the 2007 AUA/EAU Guideline for the Management of Ureteral Calculi are still valid.