Clinical Practice Guidelines for Ureteral Stones: Implications in Japan and Limitations

  • Eiji Higashihara
Conference paper
Part of the Recent Advances in Endourology book series (ENDOUROLOGY, volume 3)


Owing to the development of systematic and structured abstraction methods, evidence-based guidelines have been proposed in many disciplines. mainly in the United States of America [1]. A social background which forces practitioners to draw up clinical guidelines is especially strong in the USA, where the medical supply system is exposed to a market economy. The problem of escalating medical costs in the USA prompted the government and the medical insurance companies to introduce clinical practice guidelines. These guidelines were introduced to control medical costs and quality, because many studies had shown wide variations in physician practice patterns and the use of the health services [1]. The health services are used inappropriately in some cases, and the health outcome is made uncertain by the use or nonuse of the various services and procedures. Initially, it was mainly the users of the services who began to develop guidelines, but professionals soon recognized the importance of clinical practice guidelines. The involvement of diverse groups in guidelines development has intensified the need to create and improve scientific methods to develop these guidelines, otherwise they will not be accepted by all groups whatever their economic interests and attitudes.


Clinical Practice Guideline Extracorporeal Shockwave Lithotripsy Ureteral Stone Ureteral Calculus Impacted Stone 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Field MJ, Lohr KN (1992) Guidelines for clinical practice. National Academy Press, Washington. DCGoogle Scholar
  2. 2.
    Segura JW, Preminger GM, Assimos DG, Dretler SP Kahn RI. Lingeman JE. Macaluso JN (1997) Report on the management of ureteral calculi. The American Urological Association Ureteral Stones Clinical Guidelines PanelGoogle Scholar
  3. 3.
    Segura JW, Assimos DG. Dretler SP, Kahn RI, Lingeman JE, Preminger GM, Macaluso JN, McCullough DL, Roehrborn CG (1994) Report on the management of staghorn calculi. The American Urological Association Ureteral Stones Clinical Guidelines PanelGoogle Scholar
  4. 4.
    Bierkens AF, Hendrikx AJM, De La Rosette JJMCH, Stultiens GNM, Beerlage HP. Arends AJ, Debruyne FMJ (1998) Treatment of mid and lower ureteric calculi: extracorporeal shock-wave lithotripsy vs. laser ureteroscopy. A comparison of costs, morbidity and effectiveness. Br J Urol 81: 31–35Google Scholar
  5. 5.
    Park H, Park M, Park T (1998) Two-year experience with ureteral stones: extracorporeal shockwave lithotripsy v. ureteroscopic manipulation. J Endourol 12: 501–504PubMedCrossRefGoogle Scholar
  6. 6.
    Osti AH, Hofmockel G. Frohmuller H (1997) Ureteroscopic treatment of ureteral stones: only an auxiliary measure of extracorporeal shockwave lithotripsy or a primary therapeutic option? Urol Int 59: 177–181PubMedGoogle Scholar
  7. 7.
    Dretler SP, Keating MA, Riley J (1986) An algorithm for the management of ureteral calculi. J Urol 136: 1190–1193PubMedGoogle Scholar
  8. 8.
    Morgentaler A Bridge SS, Dretler SP (1990) Management of the impacted ureteral calculus. J Urol 143:263–266Google Scholar
  9. 9.
    Roberts WW, Cadeddu JA, Micali S, Kavoussi LR (1998) Ureteral stricture formation after removal of impacted calculi. J Urol 159: 723–726PubMedCrossRefGoogle Scholar
  10. 10.
    Singal RK, Denstedt JD (1997) Contemporary management of ureteric stones. Urol Clin North Am 24: 59–70PubMedCrossRefGoogle Scholar
  11. 11.
    Hendrikx AJM, Strijbos WEM, de Knijff DW, Kums JJM, Doesburg WH, Lemmens WAJG (1999) Treatment for extended mid and distal ureteral stones: SWL or ureteroscopy? Results of a multicenter study. J Endourol 13: 727–733Google Scholar
  12. 12.
    Sonoda T (1989) Assessment guideline for treatment of urolithiasis by endourology and ESWL. Jpn J Urol (Nihon Hinyokika Gakaizashi) 80: 505–506Google Scholar
  13. 13.
    Clayman RV, McClennan BL, Garvin TJ, Denstedt JD, Andriole GL (1989) Lithostar: an electromagnetic acoustic shock wave unit for extracorporeal lithotripsy. J Endourol 3: 307–313CrossRefGoogle Scholar
  14. 14.
    Srivastava A, Ahlawat R, Kumar A, Kapoor R. Bhandari M (1992) Management of impacted upper ureteric calculi: results of lithotripsy and percutaneous litholapaxy. 70: 252–257Google Scholar
  15. 15.
    Lingeman JE, Sonda LP, Kahnoski RJ, Coury TA. Newmwn DM, Mosbaugh PG, Mertz JHO, Steele RE, Frank B (1986) Ureteral stone management: emerging concepts. J Urol 135: 1172–1174PubMedGoogle Scholar
  16. 16.
    Tanahashi Y, Kuwahara M, Kanbe K, Chiba Y, Kuros S, Kageyama S, Numata I. Orikasa S (1986) Transurethral ureterolithotripsy (first report). Jpn J Urol 77: 1082–1088Google Scholar
  17. 17.
    Ono Y, Hirabayashi S, Yamada S, Ohosima S, Kinukawa T. Matuura O. Katoh N. Sugiyma T, Watanabe J (1987) Transurethral lithotripsy: preliminary report. Jpn J Urol 78: 1917–1922Google Scholar
  18. 18.
    Weiberg JJ, Ansong K, Smith AD (1987) Complications of ureteroscopy in relation to experience: report of surgery and another experience. J Urol 137: 384–385Google Scholar
  19. 19.
    Govier FE, Gibbon RP, Correa RJ, Brannen GE, Welssman RM. Pritchett TR (1990) Pulsed-dye laser fragmentation of ureteral calculi: a review of the first 50 cases performed at Virginia Mason Medical Center. J Urol 143:685–686Google Scholar
  20. 20.
    Fugelso P, Neal PM (1991) Endoscopic laser lithotripsy: safe, effective therapy for ureteral calculi. J Urol 145: 949–951PubMedGoogle Scholar
  21. 21.
    Vorreuther R (1992) Minimally invasive ureteroscopy using adjustable electrohydraulic lithotripsy. J Endourol 6: 47–50CrossRefGoogle Scholar
  22. 22.
    Van Deursen H, Pottomvils G, Boving R, Baert L (1991) Pulsed-dye laser lithotripsy. Which laser fiber is preferable? Critical evaluation in 204 consecutive lasertripsies. J Endurol 5: 301–305CrossRefGoogle Scholar
  23. 23.
    Murthy PV, Rao HSG, Meherwade S, Rao S, Srivastava A, Sasidharan K (1997) Ureteroscopic lithotripsy using a mini-endoscope and Swiss lithoclast: experience in 147 cases. J Endourol 11: 327–330PubMedCrossRefGoogle Scholar
  24. 24.
    Gould DL (1998) Holmium:YAG laser and its use in the treatment of urolithiasis: our first 160 cases. J Endourol 12: 23–26PubMedCrossRefGoogle Scholar
  25. 25.
    Grasso M. Bagley D (1998) Small-diameter. actively deflectable, flexible ureteropyeloscopy. J Urol 160: 1648–1654Google Scholar
  26. 26.
    Tawfiek ER, Bagley D (1999) Management of upper urinary tract calculi with ureteroscopic techniques. Urology 53: 25–31PubMedCrossRefGoogle Scholar

Copyright information

© The Japanese Society of Endourology and ESWL 2001

Authors and Affiliations

  • Eiji Higashihara
    • 1
  1. 1.Department of UrologyKyorin University School of MedicineMitaka, TokyoJapan

Personalised recommendations