Ultrasound Localization of Whole-Level Ureteral Stone for Extracorporeal Shock Wave Lithotripsy-Early Experience

Abstract

Ultrasound localization of ureteral stones for in situ extracorporeal shock wave lithotripsy(ESWL) treatment is thought to be either very difficult or possible only for proximal and distal ureteral segment. A total 36 cases of ureteral stone were reviewed at TAinan Municipal Hospital from September 1992 to December 1992. All stones were located within the segment 5 cm below the ureteropelvic junction and 4 cm above the ureterovesical junction. An in-line scanner of Dornier MPL9000 lithotriptor was used for first-line ultrasound stone localization. The success rate within this segment was 86.1%(31/36). A total of 31 stones with successful localization were treated with in situ stone disintegration, using the lithotripter. No auxiliary management prior to ESWL treatment was used and no anesthesia was needed during the treatment. The overall success rate in rendering patients free of stone was 83.9% (26/31). The success rate was increased to 92% (23/25) for those ureseral stones with a transverse diameter less than 10 mm. In conclusion, it is believed that ultrasound localization of whole-level ureteral stones is possible, and not so difficult as previously reported. With enough experience and patience in ultrasound localization, Dornier MPL9000 lithotriptor is available, safe and effective for in situ ESWL treatment of most of the ureteral stones.