Department of Urology, Wakayama Medical University, Wakayama, Japan.
Department of Urology, Hara Genitourinary Hospital, Kobe, Japan.
Int J Urol. 2022 Aug;29(8):799-806. doi: 10.1111/iju.14908. Epub 2022 Apr 27.
Treatment of urolithiasis, a benign disease, requires high efficacy and safety. Endoscopic treatment of impacted ureteral stones remains a challenging procedure for urologists, despite recent remarkable advances in surgical technology in treatment of urolithiasis. The success rate of endoscopic treatment in patients with impacted stones is reported to be lower than that in patients with nonimpacted stones. Moreover, the presence of stone impaction is associated with high rates of intraoperative and postoperative complications. The best management for patients with impacted ureteral stones should therefore be devised based on the latest knowledge and techniques. The present review focuses on the preoperative prediction of stone impaction, the safest and most effective endoscopic surgical procedures, and the most appropriate management for postoperative ureteral strictures. We overview comprehensive endoscopic management for impacted ureteral stones based on literature review and expert opinions.
治疗良性疾病尿石症需要高疗效和高安全性。尽管近年来治疗尿石症的外科技术取得了显著进展,但是对于泌尿科医生来说,处理嵌顿性输尿管结石仍然是一项具有挑战性的操作。有报道称,内镜治疗嵌顿性结石的成功率低于非嵌顿性结石。此外,结石嵌顿与术中及术后并发症的发生率高有关。因此,应根据最新的知识和技术为嵌顿性输尿管结石患者制定最佳的管理方案。本文重点介绍了术前预测结石嵌顿、最安全有效的内镜手术方法以及术后输尿管狭窄的最佳处理方法。我们通过文献回顾和专家意见综述了全面的内镜处理嵌顿性输尿管结石的方法。