Middle Ureteral Stones: Results of In Situ Extracorporeal Shock Wave Lithotripsy with EDAP LT-01 Lithotripters

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Abstract
It has been stated that because middle ureteral stones are difficult to detect ultrasonographically, they are not amenable to in situ treatment with EDAP LT-01 lithotripters. In our hands, 15 of 79 patients (mean age 45.1 years) with middle ureteral stones averaging 11.2 mm were successfully treated with an EDAP LT-01 lithotripter with the stones in situ. With an Aloka SSD-650 hand probe, the common iliac vessels were visualized; while the patient was kept prone and using the vessels as a landmark, these stones were detected along dilated ureters and focused on by machine's self-contained probe. In three patients, the stones were not relocated by the EDAP probe because of obesity or nondilated ureters. Of 16 patients whose stones could be focused on by the probe, 15 were treated successfully. Our method of using the common iliac vessels as a landmark for locating and focusing on middle ureteral stones allows us to expand the treatment possibilities of EDAP LT-01 lithotripters.