Makale Arama

Selection of primary mode of therapy for lower ureteral stones is stili controversial, should it be ESVVL (Extracorporeal shock wave lithotripsy) or ureteroscopic approach? ESVVL therapies were applied to 321 patients. Ultrasonographic targetings were used when stones could be localised by ultrasound in 131 patients (Group I), fluoroscopic targetings were used in 186 patients (Group II) during ESVVL treatment. Uretroscopic approach was selected in 121 patients as a primary treatment of lower ureteral stones. (Group III) Total success rates were 85% for ESVVL treatment and 94.4% for ureteroscopic approach. (P=0.015) Success rates were 91.1% and 80.6% in Group 1 and 2 subsequently. (P=0.015) Retreatment rate was clearly lower in group I (11.8%)than the group II (26.3%). (P=0.001) Success rate of ureteroscopic approach was compared to ESVVL groups, vvhile there was no d if ference with group I, (P=0.048) success rate of grup III was higher than group ll.(P=0.002) Complication rates showed significant difference between ESVVL and ureteroscopy groups.(13.2% versus 3.7%)(P=0.004) VVe concluded that ESVVL should be selected as a primary therapy of lower ureteral stones that can be seen by ultrasound due to its the higher success and lower complication rates than the ureteroscopic approach.

Initially extracmporeal shock wave lithotripsy (ESWL) was used for mechanical stimulation of asy-stolic heart and was larer to be used routinelv for urinary and gall bladder stone extraction. Soıne re-ported preliminary studies imply that ESWL can be used to treatment pseucloarthrosis, delayed union. epicondilitis, tendinosis calcarea and prostetic re-vision. Between July 1994- October 1995, in de-partment of Orthopedics and Traumatology, Me-dical Faculty, Selçuk University a study was undertaken for 5 patients with tihial pseudoarthrosis. For this purpose Dornier MFL 9000 lithotripter was used. An intensity of 20-22 kV. totalling 3000 pul ses were applied to the end of each fracture. Solid ttili011 was achieved on an average of 4 months (ranging 3-6 months). As a result of Iliis study, the technique ofkrs a potantial altrenative rreatment modality for cases for whom other techniques can be used with difficulty and for pseudoarthrosis which mav develop after opeıı fractures.

is a method used especially in the tre-atment of urinary and biliary tract stones. A recent model is also used in Orthopedics. However there is a disadvantage of se-quiestration of broken pieces of stones at the level of lower calyx and leading to stone street. In this study we applied controlled inversion to stones to be fal-len down which were at a diameter of greater than 4 mm and broken by ESWL, but their pieces were se-questered at the level of lower caliyx or formed stone street. ESWL is applied to 33 patients 21 of them who had sequestered pieces at the level of lower caliyx, were treated by inversion-vibration method for 6 minutes at 45 degrees trendeblundum position, we used US with 15 Watticm2 and vib-ration to 12 patiens who had sequestered pieces for 6 minutes each while they are standing. The results were positive in 10. In addition to 12 patients wiho had primary uretery stones, only US and vibration were applied and 8 of them were fallen down. All these procedures were performed in 2-5 sessions. No significant complication was observed. As results we concluded that controlled inversion threapy is a relliable, effective and economic met-hod.

Although it is a safe and effective treatment met-hod in upper urinary tract nehprolithiasis, ESWL has some untoward effects on renal structure and function. It has been reported that verapamil, allopurinol and indomethasine have protective effects on. renal paranchyme, In order to evaluate renal functions in rabbits we studied ESWL related renal paranchymal damage reducing effects of verapamil, allopurinol and in-domethasine. We Used urinary beta NAG. GGT and beta-2 microglobutin levels as relferance. As a result we observed that ESWL. has a focal effects leading to damage on paranchyme which may be temporary ul above mentioned drugs doesn't reduce these effects orswell.