Comparative analysis of two minimally invasive surgery ways in treatment of proximal ureteral calculi after the failure of extracorporeal lithotripsy

OBJECTIVE To compare invasive surgery ways in treatment of proximal ureteral calculi after the failure of external crushed stone.METHODS Reviewed the data of 237 cases with proximal ureteral calculi after failure of external lithotripsy from June 2004-February 2010 in our hospital,then treated the patients using minimally invasive percutaneous nephrolithotomy and transurethral ureteroscopic lithotripsy and compared the effects of two ways.Of which 143 patients were treated with MPCNL;94 patients were treated with URL after the ESWL,32 patients received adjuvant therapy.RESULTS 3d after operation,clearance rate of stone in MPCNL group was 95.8%(137/143);after 1 month,clearance rate of stone was 100%(143/143).3d after operation,clearance rate of stone in URL group was 32.7% in 3d(31/94);after 1 month,clearance rate of stone was 90.5%(85/94),were significantly lower than MPCNL group(P﹤0.05).CONCLUSION Minimally invasive percutaneous nephrolithotomy in treatment of upper-ureteral calculi has a high stone clearance rate;the effect of transurethral ureteroscopic lithotripsy is worse,which can be combined extracorporeal lithotripsy to improve the efficacy of lithotripsy.