IN-SITU ECHO-GUIDED EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY OF URETERALSTONES

In 285 patients with prevesical ureteral stone and 247 with upper uret eral stone, extracorporeal shock wave lithotripsy (ESWL) was performed with the Dornier MPL 9000 ultrasonographic targeting device. All thes e stones were treated ''in situ'' and without regional or general anae sthesia. At 3-month follow-up 96.8% of the patients treated for preves ical stone and 95.5% of those with upper ureteral stone were stone-fre e. ESWL was repeated once or twice in 99 cases; the average number of sessions was 1.2 for all patients (similar for prevesical and upper ur eteral stones). Sparse use of ureteral stenting (6.2% of cases) did no t seem to reduce the efficacy of ESWL or increase complications or nee d for retreatment. Intravenous fentanyl analgesia was given to 40.9% o f the patients and intravenous infusion of a furosemide solution was e mployed in many cases to give adequate dilation of the urinary tract. In situ echo-guided ureteral ESWL is simple, safe and efficacious and can be the technique of choice for sonographically detectable ureteral stone.