Abstract:

Objective   To evaluate the efficacy and safety of ultrasound-guided  percutaneous nephrolithotomy(PCNL) in lateral position for the treatment of upper ureteral stone after failed ESWL. Methods   From June 2011 to March 2012, 53 patients with upper ureteral stones after failed ESWL underwent ultrasound-guided PCNL in lateral position. Their clinical data and complications were analyzed retrospectively. Results   All operations were successfully completed. The stones in 47 patients were completely cleared by the first attempt. 6 patients received further auxiliary measures because of postoperative residual stones after the operation. Stones of 4 patients were completely cleared,  and there were 2 patients with residual stones. The primary stone-free rate was 84.2％.The total stone free rate was 96.2%. Major complications occurred in10 patients after the operation. Overall,1 case had significant hematuria requiring blood transfusion, 9 cases got fever, and 1 case suffered from septic shock. No severe complications occurred. Conclusion   The ultrasound-guided PCNL in lateral position for the treatment of upper ureteral stone after failure of ESWL has the advantage of high stone clearance rate for the first time and high safety. It is an effective method for the treatment of upper ureteral stone after failed ESWL.

Key words: Upper ureteral stone; Percutaneous nephrolithotomy; Lateral position; Minimally invasive; Extracorporeal shock wave lithotripsy