Çağatay GÖĞÜŞ, Ercan FİLİZ, Yaşar BEDÜK, Orhan GÖĞÜŞ, Sümer BALTACI, Özcan KILIÇ

Üreter alt uç taşlarının tedavisinde ESWL ve üreteroskopi'nin karşılaştırılması

Amaç: Üreler alt uç taşlarının tedavisinde, ESWL ile üreteroskopinin (URS) başarı oranlarını retrospektif olarak karşılaştırmak. Hastalar ve Yöntem: Eylül 1999 ile Mayıs 2002 tarihleri arasında üreler alt uç taşı tanısı alan toplam 272 hasta çalışmaya dahil edildi. Üreter alt uç taşı tanısı, taşın sakroiliak bileşkenin inferior sınırının altında olması şeklinde tarif edildi. Hastalardan 161'ine URS (ortalama yaş 45.5 yıl), 111'ine ise ESWL (ortalama yaş 42.9 yıl) uygulandı. ESWL uygulanan grupta ortalama taş boyutu 9.3 mm (4-16 mm), URS uygulanan grupta ise 8.8 mm (3-20 mm) olarak tespit edildi. ESVVL intravenöz sedasyonla PCK V5 litotriptör ile gerçekleştirildi. URS 9.5F rijit üreteroskop kullanılarak ya-pıldı. Bazı vakalarda taş alımı litotripsi veya basket yardımıyla gerçekleştirildi. Bulgular: URS uygulanan 161 hastada başarı oranı % 91.4 olarak saptandı. Başarısız olunan 14 hastanın 7'sinde darlık ve/veya belirgin ödem, 4'ünde başarısız litotripsi uygu-laması ve 3'ünde komplikasyon gözlendi. ESWL uygulanan 111 hastanın , 94'ünde (%84.6) bir ay sonra taştan yoksunluk mevcuttu. Sonuç: Üreter alt uç taşlarının tedavisinde URS ve ESWL yakın başarı oranlarına sahip yöntemlerdir ve hasta tercihine göre tedavide her iki yöntemden biri uygulanabilir.

Extracorporeal schok wave lithotripsy versus ureteroscopy for the treatment of distal uretral calculi

Extracorporeal Schok Wave Lithotripsy Versus Ureteroscopy For The Treatment ofDistal Uretral Calculi Objectives: The aim ofourstudy was to compare the suc-cess rates of extracorporeal shock wave lithotripsy (ESVVL) and ureteroscopy (URS) in treatment ofdistal ureteral calculi. Patients and Methods: A total of 272 patients with distal ureteral calculi were included in this study. Distal ureteral stone diagnosis was done when the stone localized below the inferior part of sacroiliac joint. Ofthem 161 patients undenvent URS (mean age 45.5 years) and 111 under-went ESWL (mean age 42.9 years) for the treatment. The mean stone size in ESVVL group was 9.3 mm (4-16 mm) and in URS group 8.8 mm (3-20 mm). ESVVL was performed with PCK V5 lithotriptor under intravenous sedation. URS was performed with 9.5 F rigid ureteroscope. Stone removal was done with lithotripsy or bascet in some cases. Results: The overall success rate for URS was 91.4%. The failure in 14 patients was due to stenosis and severe edema in 7 patients, unsuccessful lithotripsy in 4 and compli-cations in 3. Of the 111 patients who undenvent ESVVL, 94 (84,6%) were stone free after öne month. Conclusion: URS and ESWL have similar success rates in the treatment of distal ureteral calculi and one of the procedures can be performed in treatment according to patient preference.

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