[Complications of contact ureteral lithotripsy].

ABSTRACT

Shows the current real time terminology and variants of systematization and grading of complications of contact ureteral lithotripsy (CULT). Research papers related to complications of CULT published over the last three decades were analyzed. Currently there is no clear terminology, classification, systematization and grading of CULT complications. The terms used are deficient because they do not adequately characterize specific complications of CULT. For example, some researchers define a complete ureteral avulsion as a defect at two levels, but others interpret it as a defect of the ureter at only one level. And the use of such terms as extravasation of the contrast media and/or migration of the stone outside of the ureter is groundless because these complications occur only after the perforation of the ureter wall. Therefore, these conditions are complications not of CULT but of the ureteral wall perforation. Presently, the classical classification of CULT cannot be adequately used, since it is low-structured. Universal instruments (PULS, Satava, Clavien-Dindo) have low specificity and sensitivity to CULT complications and limited possibilities of their application. Both developers of different scales of systematization of CULT complications (PULS; Satava; Clavien-Dindo) and EAU consider further international randomized studies warranted for their greater integration and adaptation.