経尿道的尿管砕石術の難易度による尿管の新区分

Abstract

Between August, 1985 and February, 1987, 4 renal pelvic stones and 49 ureteral stones (28 calculi in the abdominal ureter, 21 in the pelvic ureter) were treated by 55 procedures of transurethro-ureteral lithotripsy (TUL). The success rate for stones in the ureter lying in the paravertebral gutter was 33% (3/9), while those in the ureter overlying the psoas muscle was 85% (17/20). The success rate for calculi impacted at the uretero-vesicle junction was 100% (12/12), and those in the upper part of pelvic ureter was 80% (8/10). Two of 4 renal pelvic stones were successfully fragmented and removed. The overall success rate by the ureterorenoscope was 79% in 53 renoureteral units. Judging from our experience and results of TUL, the stone location seems to be one of the factors affecting the success rate. Thus, we propose a new classification of ureter according to success rate for TUL as follows; uretero-vesical junction, pelvic, psoas, and gutter portion.