The ancillary practice for the managent of upper ureteral stones is to push the sone up the renal pelvis before extracorporeal shock wave lithotripsy (ESWL). We evaluated 103 patients with mid and upper ureteral stones for identifying the
significant
factors of success in push up procedure. The clinical factors of success of push up procedure may be regarded to location (upper, mid), size (12mm≥,12mm<), duration of impaction (1Mo≥, 1Mo<), duration of symptoms (1 Mo≥, 1Mo<), smoothness of
the
surface of the stone (Smooth, Rough), degree of obstruction (partial, complete), pyuria or not (WBC>5, WBC≥5 in microscopic urinalysis).
Our results showed that the success rate of push up were 92.7%, 96.3%, 92.9%, 93.3%, 96.6%, 94.4%, and 93.5% in the case of upper ureter stone, less than 12 mm in diameter in stone size, less than 1 month in duration of initial symptoms and
impaction,
smooth stone surface, partial obstruction, presence of pyuria, respectively compared to 28.6%, 60.7%, 68.4%, 53.3%, 77.8%, 75%, and 84.2% in the case of mid ureter stone, more than 12mm in diameter, more than 1 month in duration of initial
symptoms
and
impaction, rough stone surface, complete obstruction, absence of pyuria respectively. These are clinically significant factros of affe cting success in push up procedure (P<0.05) except appearance of pyuria or not (P>0.05).
Complications of push up were infrequent, with hematuria (30.7%), flank pain (29.7%), and ureteral perforation (2.2%), all of which were managed conservatively.
From these data we conclude that upper ureter stones with successful clinical factors should be tried push-up into the renal pelvis before ESWL to improve the therapeutic results.
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