1450 A PROSPECTIVE RANDOMIZED COMPARISON BETWEEN SHOCK WAVE LITHOTRIPSY AND SEMI-RIGID URETEROSCOPY FOR UPPER URETERIC STONES LESS THAN 2 CM: A SINGLE CENTRE EXPERIENCE

Abstract

You have accessJournal of UrologyStone Disease: SWL, Ureteroscopic or Percutaneous Stone Removal I1 Apr 20101450 A PROSPECTIVE RANDOMIZED COMPARISON BETWEEN SHOCK WAVE LITHOTRIPSY AND SEMI-RIGID URETEROSCOPY FOR UPPER URETERIC STONES LESS THAN 2 CM: A SINGLE CENTRE EXPERIENCE Anup Kumar, Manoj Jain, Sanjay Prakash, and Nayan Mohanty Anup KumarAnup Kumar More articles by this author , Manoj JainManoj Jain More articles by this author , Sanjay PrakashSanjay Prakash More articles by this author , and Nayan MohantyNayan Mohanty More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1164AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We have performed a prospective randomized comparison between semi-rigid ureteroscopy and shock wave lithotripsy for upper ureteric stones less than 2 cm to evaluate safety and efficacy of these procedures. METHODS All the patients with a single radio-opaque upper ureteric stone < 2 cm undergoing treatment between Jan 2008 and May 2009 in our department were included. Patients were randomized into 2 groups – Group A: SWL was performed as an outpatient procedure using the electromagnetic lithotripter (Dornier Alpha Compact); Group B: URS was performed using an 6/7.5 F or 8/9.8 F semirigid ureteroscope with pneumatic or holmium laser intracorporeal lithotripsy energy. The statistical analysis was performed in 2 groups regarding patient demographic profile, success rates, retreatment rates, auxiliary procedures, and complications. RESULTS 90 patients were enrolled in each group. The mean stone size was 12.3 mm in group A vs. 12.5 mm in group B (p= 0.52). The overall 3 month stone free rate was (74/90)82.2% for group A vs (78/90)86.6% for group B (p=0.34).For stone size < 10 mm, 3 month stone free rates were (43/51) 84.3% for group A vs (44/51)86.3% for group B(p=0.32).For stone size between 10-20 mm, 3 month stone free rates were (31/39)79.5% for group A vs (35/39)89.7% for group B(p=0.12).The retreatment rate was significantly greater in group A in comparison to group B (61.1% vs 1.1%, respectively; p = 0.001). The auxiliary procedure rate was comparable in both groups (21.1% vs 17.7%; p=0.45). The complication rate was 6.6% in group A vs 11.1% in group B (p=0.21). CONCLUSIONS Both SWL and semirigid URS are safe and highly efficacious in the treatment of proximal ureteral stones < 20mm.For upper ureteric stones < 10 mm,SWL was safer, less invasive and with comparable efficacy in comparison to URS.However,for upper ureteric stones between 10-20 mm,URS was more effective, with a lesser retreatment rate than SWL. Delhi, India© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e559 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anup Kumar More articles by this author Manoj Jain More articles by this author Sanjay Prakash More articles by this author Nayan Mohanty More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...