Abstract
An impacted stone is defined as a stone where a guidewire will not pass without ancillary measures and/or a stone that does not move when forceful irrigation is applied ureteroscopically. Ureteral stone impaction is known to cause a local inflammatory response in the ureteral wall, thus caution should be exercised during the treatment of impacted ureteral stones as they are at a high risk for ureteral perforation and can predispose to ureteral stricture. We recommend an antegrade ureteroscopic approach for impacted stones >10 mm and a retrograde approach for impacted ureteral stones <10 mm. There is limited role for shock wave lithotripsy for impacted ureteral stones. In this chapter we describe our step-by-step approach for the treatment of an impacted ureteral stone.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Morgentaler A, Bridge SS, Dretler SP. Management of the impacted ureteral calculus. J Urol. 1990;143:263–6.
Mugiya S, Maruyama S, Hadano S, Nagae H. Endoscopic features of impacted ureteral stones. J Urol. 2004;171:89–91.
Huffman JL, Bagley DH, Lyon ES. Abnormal ureter and intrarenal collecting system. In: Urologic endoscopy: a manual and atlas. Boston: Little Brown and Co.; 1985. p. 59–73. Chapter 6.
Roberts WW, Cadeddu JA, Micali S, et al. Ureteral stricture formation after removal of impacted calculi. J Urol. 1998;159:723–6.
Preminger GM, Tiselius HG, Assimos DF, et al. 2007 Guideline for the management of ureteral calculi. J Urol. 2007;178:2418–34.
El-Barky E, Ali Y, Sahsah M, et al. Site of impaction of ureteric calculi requiring surgical intervention. Urolithiasis. 2014;42:67–73.
Chaussy CG, Fuchs GJ. Current state and future developments of noninvasive treatment of human urinary stones with extracorporeal shock wave lithotripsy. J Urol. 1989;141:782–9.
Khalil M. Management of impacted proximal ureteral stone: extracorporeal shock wave lithotripsy versus ureteroscopy with holmium: YAG laser lithotripsy. Urol Ann. 2013;5:88–92.
Wu CF, Shee JJ, Lin WY, et al. Comparison between extracorporeal shock wave lithotripsy and semirigid ureterorenoscope with holmium:YAG laser lithotripsy for treating large proximal ureteral stones. J Urol. 2004;172:1899–902.
Mugiya S, Nagato M, Un-No T, et al. Endoscopic management of impacted ureteral stones using a small caliber ureteroscope and a laser lithotripter. J Urol. 2000;164:329–31.
Maheshwari PN, Oswal AT, Andankar M, et al. Is antegrade ureteroscopy better than retrograde ureteroscopy for impacted large upper ureteral calculi? J Endourol. 1999;13:441–4.
Li H, Na W, Li H, et al. Percutaneous nephrolithotomy versus ureteroscopic lithotomy for large (>15 mm) impacted upper ureteral stones in different locations: is the upper border of the fourth lumbar vertebra a good indication for choice of management method? J Endourol. 2013;27:1120–5.
Adiyat KT, Meuleners R, Monga M. Selective postoperative imaging after ureteroscopy. Urology. 2009;73:490–3.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Coleman, S.L., Monga, M. (2015). Difficult Case: The Impacted Ureteral Stone. In: Patel, S., Nakada, S. (eds) Ureteral Stone Management. Springer, Cham. https://doi.org/10.1007/978-3-319-08792-4_13
Download citation
DOI: https://doi.org/10.1007/978-3-319-08792-4_13
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-08791-7
Online ISBN: 978-3-319-08792-4
eBook Packages: MedicineMedicine (R0)