Abstract
The article dedicate to the problem of failure of extracorporeal shockwave lithotripsy in patients with ureterolithiasis and reveal the changes which appear in the ureter in the location of the stone.The aim. Analysis of the results of treatment in patients, suffering ureteric stones, using the ureterolithotripsy procedure after failure extracorporeal shockwave lithotripsy.
 Materials and methods. In 137 patients with ureteric stones, whom ureterolithotripsy procedure after failure extracorporeal shockwave lithotripsy was conducted, the symptoms of the disease, the diagnostic methods value, efficacy of surgical treatment and reasons of the failure of previous method of treatment were analyzed.
 Results. In 135 patients endoscopic removal of stones has been succeeded, in 2 patients because of total obliteration of the ureter, uretero-ureteral anastomosis has been performed. If the symptoms, with are characteristic of ureterolithiasis, persists up to one week stones don’t cause significant macroscopic changes to the ureter wall. If the stone persists in the ureter longer than a week we identified local appearing of oedema. Long–term (more than two months) ureteric stone persistence increase the risk of intramucosal “ingrowth” of the calculi greatly.
 Conclusion. The URS and ESWL are high effective and minimal invasive methods of surgical intervention for patients with ureterolithiasis, guaranteeing high level of postoperative “stone free rate”. Prolongation of the stone insertion time in the ureter causes the ureteric wall changes, complicating performance of minimal invasive interventions (ureterolithotripsy and extracorporeal shock–wave lithotripsy) and reduce its efficacy.
Highlights
Urolithiasis is a term used to describe stones that are formed in the urinary tract
Ureterolithiasis is a high recurrence risk disease, 40 % of patients recur within 5 years and 75 % recur within 20 years [2]
Materials and methods Annually in the clinical departments of state institution «Institute of Urology of National Academy of Medical Sciences of Ukraine» more than 650 patients with ureterolithiasis are treated by extracorporeal shockwave litho tripsy (ESWL)
Summary
Urolithiasis is a term used to describe stones that are formed in the urinary tract. It involves the formation of calculus in the urinary system, mainly in the kidneys which can move through the urinary system causing pain (renal colic), blood in urine, fever and inflammation. Diagnostic visualization of kidney and ureteral stones is primary done by ultrasound (US) examination, which is safe, inexpensive and real-time. It can identify stones located in the kidney calyces, pelvis, pyeloureteric junction, all localisation of the ureter, as well as the upper urinary tract dilatation. CT for urolithiasis shows sensitivity of 93.1 % and a specificity of 96.6 % for stones bigger than 3 mm [7, 8]
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