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European UrologyVolume 61, issue 4, pages e23-e40, April 2012
Contemporary Management of Ureteral Stones
Accepted 5 January 2012, Published online 14 January 2012, pages 764 - 772
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.
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.
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.
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.
Ureteral stones of up to 10 mm 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.
Keywords: Ureteral calculi, Medical expulsive therapy (MET), Lithotripsy, Ureterorenoscopy, Extracorporal shockwave lithotripsy (SWL), Antegrade percutaneous litholapaxie (PCNL), Laparoscopic stone treatment.
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