針對嚴重輸尿管結石堆積的特殊治療方式

 陳兆宏 吳翊豪 陳鴻毅 林政鋒 劉冠麟 吳俊德 陳文祥 林承家

基隆長庚醫院 外科部 泌尿科

Special treatment for severe ureteral stones impaction

Chao-Hung Chen, Yi-Hao Wu, Hong-Yi Chen, Cheng-Feng Lin, Kuan-Lin Liu , Chun-Te Wu, Wen-Hsiang Chen, Cheng-Chia Lin

Divisions of Urology, Department of Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan

Abstract:

The impacted ureteral stones means the stones are fixed in the same location for a period of time with local inflammation. The stone street or steinstrasses always happened after ureteroscopy with laser lithotripsy or shock wave lithotripsy and resulted in an stone accumulation within ureter.It is difficult to treat these impacted stone due to lack of expansion space behind the stone, which cause the stone disintegration to less effective and a higher complication rate.Therefore, we present our experience of using a ureteral access sheath (UAS) assisted with ureteral catheter to wash out stone chips after stone disintegration with ureteroscopy.This procedure can improve the expansion space behind the stone while clearance of impacted ureteral stone. It costed less time for stone clearance than using stone basket and less thermal injury over ureter mucosa. As our experience,impacted stone treatment with ureteroscopy and ureter catheter irrigation is an effective and safe treatment, which increase stone-free rates and prevent steinstrasse related post-operative ureteral injury.