Abstract
Currently, an ideal gadget to stop retrograde stone migration remains a holy grail, and the hunt for such a device is still ongoing in the 21st century. The quest for an ideal instrument is driven by the need to reduce cost, minimize ancillary procedure rates, reduce the device's operative time, and improve the stone-free rate. The purpose of the present review is to provide an update on the use of preventive measures that are used to stop retrograde stone migration during pneumatic lithotripsy for ureteric stone management.
Highlights
BackgroundUreteroscopic pneumatic lithotripsy for the treatment of ureteric calculi is quite a common modality [1]
The migration depends on various factors; it can be triggered by the jet of irrigation fluid, type of energy source used for intracorporeal lithotripsy, location of the calculus in the ureter and the degree to which it is impacted there, as well as the degree of proximal ureteral dilation [3]
Separate searches were performed with the following search terms: "anti-retropulsion device", "ureteric stones", "pneumatic lithotripsy", "retrograde stone migration", stone-free rates, and "ureteroscopy"
Summary
BackgroundUreteroscopic pneumatic lithotripsy for the treatment of ureteric calculi is quite a common modality [1]. Proximal migration of the calculi during lithotripsy has been reported to range from 3-48% in the literature [2]. The migration depends on various factors; it can be triggered by the jet of irrigation fluid, type of energy source used for intracorporeal lithotripsy, location of the calculus in the ureter and the degree to which it is impacted there, as well as the degree of proximal ureteral dilation [3]. Electrohydraulic and pneumatic lithotrites are more prone to retrograde migration of calculi compared to other devices like ultrasonic or holmium:yttrium-aluminum-garnet (Ho:YAG) lasers [4]. The proximal migration of the calculi is more when the stones are smaller or when the diameter of the proximal ureter is larger, e.g., in hydronephrosis [3]
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