Yaşar BOZKURT, Ahmet Ali SANCAKTUTAR, Sezgin YAĞCI, Murat KAPAN, Hacı MURAT

Üreter Taşları: 146 Olguda ESWL Tedavisi Sonuçları

Amaç: Üreter taşlarında ESWL tedavisi ile başarı oranları ve başarıyı etkileyen faktörleri incelemek. Materyal ve Metot: Ocak 2007 ile Ağustos 2008 tarihleri arasında Tıp merkezimizde üreter taşları nedeni ile ESWL tedavisi verilen 146 hastaya ait bilgiler retrospektif olarak incelendi. Hastaların tedavi sonuçları, taşsızlık ve başarısızlık oranları ve komplikasyon gelişme sıklığı belirlendi.Bulgular: Hastaların ortalama yaş ve taş boyutu, sırasıyla 39 yıl ve 10.3 mm idi. Ortalama 2.5seans ESWL uygulanmıştı ve ortalama şut sayısı 4066 idi. İşlemden 3 hafta sonra başarı oranı total olarak % 69.2 bulundu. Alt, orta ve üst üreter taşı olan hastaların sayısı sırasıyla; 59 (%40.4), 32 (%21.9) ve 55 (%37.7) idi. Alt, orta ve üst üreter taşı olan hastalar arasında yaş, taş boyutu, şut sayısı, seans sayısı ve taşsızlık ve komplikasyon oranları bakımından anlamlı bir farklılık saptanmadı (P>0.05). Taş boyutu ile taşsızlık arasında negatif korelasyon saptandı (r=-0.340, P

Anahtar Kelimeler:

Üreter taşları, ESWL, etkinlik, taşsızlık oranı

Ureteral Stones: Results of ESWL Treatment in 146 Patients

Aim: The aim of this study was to evaluate the success rate and factors that effective on stone-free ratio.Materials and methods: Data belong to 146 patients with ureteral stones that treated by ESWL between January 2007 and August 2008, were retrospectively reviewed. Treatment outcome, stone-free and treatment failure ratios and frequency of complications were determined.Results: The mean age and stone diameter of patients were 39 years and 10.3 mm , respectively. Mean of 2.5 séance ESWL was applied at the 4066 shoots. The overall stone-free ratio was 69.2% after 3 weeks of ESWL. No significant difference was found in patients’ age, stone-diameter, amount of shoot and stone-free ratio between lower, mid and upper ureteral stones (P>0.05). A significant negative correlation was found between stone diameter and stone-free ratio (r=-0.340, P

Keywords:

ESWL, ureteral stones, effectiveness, stone-free ratio,

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Anderson KR, Keetch DW, Albala DM, Chandhoke PS, McClennan BL, Clayman RV: Optimal therapy for the distal ureteral stone: Extracorporeal shock ureteroscopy. J Urol. 152: 62-65, 1994.
versus 2. Wolf JS, Clayman RV: Percutaneous nephrostolithotomy: What is its role in 1997? Urol Clin North Am. 24: 43, 1997.
Tiselius HG, Ackermann D, Alken P, Buck C, Conort P, Gallucci M: Guidelines on urolithiasis. Eur Urol. 40: 362, 2001.
Mobley TB, Myers DA, Jenkins JM, Grine WB, Jordan WR: Effects of stents on lithotripsy of ureteral calculi: treatment results with 18,825 calculi using the Lithostar lithotripter. J Urol.152:66-67, 1994.
Preminger GM, Tiselius HG, Assimos DG, et al. 2007 Guideline for the Management of Ureteral Calculi. J Urol.178: 2418-2434, 2007. 6.
Portis AJ, Yan Y, Pattaras JG, Andreoni C, Moore R, Clayman RV: Matched pair analysis of shock wave lithotripsy comparison of lithotripters. J Urol. 169:58-62, 2003.
for 7. Abdel-Khalek M, Sheir K, Elsobky E, Showkey S, Kenawy M: Prognostic factors for extracorporeal shockwave lithotripsy of ureteric Stones: a multivariate analysis study. Scand J Urol Nephrol. 37: 413-418, 2003.
Shiroyanagi Y, Yagisawa T, Nanri M, Kobayashi C, Toma H: Factors associated
extracorporeal shock wave lithotripsy for ureteral stones using Dornier lithotripter U/50. Int J Urol. 9: 304- 309, 2002. failure
of 9. Ahmed EA, Ahmed REN, Ramy FY, Ahmed SEH, Khaled ZS: Distal üreter taşlarında hidronefroz derecesi ESWL başarısını etkilemekte midir? Urology (Türkçe baskı). 3: 24-29, 2007.
Peschel R, Janetschek G, Bartsch G: Extracorporeal shock wave lithotripsy versus ureteroscopy for distal ureteral calculi: a prospective randomized study. J Urol. 162: 1909-1912, 1999.
Pardalidis NP, Kosmaoglou EV, Kapotis
extracorporeal shock wave lithotripsy in the treatment of distal ureteral stones: ten years experience. J Endourol. 13:161-164, 1999.
vs. 12. Pearle MS, Nadler R, Bercowsky E, et al. Prospective randomized trial comparing shock wave lithotripsy and ureteroscopy for management of distal ureteral calculi. J Urol. 166: 1255- 1260, 2001.
Virgili C, Mearini E, Micali S, Miano R, Extracorporeal shockwave lithotripsy of ureteral stones: lithotripters Endourol.13:543-547, 1999. M: are second-generation obsolete?
J 14. Ather MH, Paryani J, Memon A, Sulaiman MN: A 10-year experience of managing ureteric calculi: changing trends
intervention - is there a role for open surgery? BJU Int. 88: 173-177, 2001.
Mobley TB, Myers DA, Jenkins JM, Grine WB, Jordan WR: Effects of stents on lithotripsy of ureteral calculi: treatment results with 18,825 calculi using the Lithostar lithotripter. J Urol. 152: 66-67, 1994.
Drach GW, Dretler S, Fair W, et al: the Report
cooperative study of extracorporeal shock wave lithotripsy. J Urol. 135: 1127-1130, 1986. United
States 17. Kim CS, Moon TY, Kim DK: ESWL monotherapy, piezoelectric
lithotriptor in 642 patients. J Urol. 142: 674-678, 1989. with second generation