Urology reports (St. - Petersburg)Urology reports (St. - Petersburg)Урологические ведомостиUrology reports (St. - Petersburg)2225-90742687-1416Eco-Vector63008810.17816/uroved630088ReviewsНаучные обзорыReviewsReview ArticleCurrent approaches to the selection of treatment methods for patients with upper ureteral stonesСовременные подходы к выбору метода лечения пациентов с камнями в верхней трети мочеточникаhttps://orcid.org/0009-0008-7603-1491PachuliyaZaur V.ПачулияЗаур Вячеславович
Russian Federation

MD

pachuliya.zaur@gmail.comhttps://orcid.org/0009-0005-1762-61006147-7357ParonnikovMikhail V.ПаронниковМихаил Валериевич
Russian Federation

MD, Dr. Sci. (Medicine)

д-р мед. наук

paronnikov@mail.ruhttps://orcid.org/0000-0002-4996-29276289-4250ProtoshchakVladimir V.ПротощакВладимир Владимирович
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

protoshakurology@mail.ruKirov Military Medical AcademyВоенно-медицинская академия им. С.М. Кирова150220250705202515189990704202415022025Copyright ©; 2025, Eco-VectorCopyright ©; 2025, Эко-ВекторCopyright ©; 2025,2025Eco-VectorЭко-Векторhttps://eco-vector.com/for_authors.php#07https://journals.eco-vector.com/uroved/article/view/630088

Urolithiasis occupies one of the leading places in the structure of urological diseases. In this case, ureterolithiasis is observed in at least 50% of cases. Of all the localizations of stones in the ureter, the most difficult problem is stones in the upper third, since with this location of the calculus, a wide range of treatment methods with different effectiveness and safety profiles can be selected. The review includes modern publications on studies of the effectiveness of conservative and surgical methods of treating patients with stones in the upper third of the ureter, including lithokinetic and litholytic therapy, remote shock wave lithotripsy, contact ureterolithotripsy, laparoscopic ureterolithotomy, and also describes the factors influencing the choice of treatment method. The results of using various methods of surgical treatment of ureterolithiasis, the likelihood of additional interventions, the frequency, nature and degree of intraoperative and postoperative complications were analyzed. It is emphasized that the introduction of new technologies has changed approaches to the choice of treatment method for patients with upper ureter stones, which has increased its effectiveness and reduced the risk of complications. At the same time, many aspects of surgical treatment of patients with upper ureter stones remain a subject of debate.

Мочекаменная болезнь занимает одно из лидирующих мест в структуре урологических заболеваний. При этом уретеролитиаз наблюдается не менее чем в 50% случаев. Из всех локализаций камней в мочеточнике наиболее сложную проблему представляют камни в верхней трети, поскольку при данном расположении конкремента возможен выбор широкого спектра методик лечения, обладающих разной эффективностью и профилем безопасности. В обзор включены современные публикации по исследованиям эффективности консервативных и хирургических методов лечения пациентов с камнями в верхней трети мочеточника, в том числе литокинетической и литолитической терапии, дистанционной ударно-волновой литотрипсии, контактной уретеролитотрипсии, лапароскопической уретеролитотомии, а также описаны факторы, влияющие на выбор метода лечения. Были проанализированы результаты применения различных методов хирургического лечения уретеролитиаза, данные о вероятности дополнительных вмешательств, частоте, характере и степени интраоперационных и послеоперационных осложнений. Подчеркнуто, что внедрение новых технологий изменило подходы к выбору метода лечения пациентов с камнями верхней трети мочеточника, что позволило повысить его эффективность и снизить риск развития осложнений. При этом многие аспекты хиругического лечения больных с камнями верхней трети мочеточников остаются предметом дискуссий.

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