Abstract
ObjectiveThe goal of this study was to compare the effectiveness and complications of ureteroscopic pneumatic lithotripsy (URS) and extracorporeal shock wave lithotripsy (SWL) in the management of patients with proximal ureteral stones.MethodsIn this trial, 150 patients presenting with proximal ureteral stones at the Department of Urology of Nishter Hospital Multan from November 2018 to November 2019 were allocated 1:1 to undergo URS or SWL. The presence of stone fragments <4 mm on follow-up was regarded as being stone free. The study outcomes included stone-free rates after first, second, and third treatment sessions and stone retropulsion into the kidneys.ResultsA total of 75 patients each underwent URS and SWL. The mean procedure times for SWL and URS were 61.61± 3.21 and 85.01±6.75 minutes, respectively (P=0.000), and the mean numbers of procedures were 1.51±0.49 and 1.01±0.42, respectively (P=0.000). Stone-free rates after the first, second, and third sessions of SWL were 64%, 77.3%, and 94.7%, respectively, whereas stone-free rates after the first, second, and third sessions of URS were 86.7%, 92%, and 100%, respectively. Rates of stone retropulsion into the kidneys in the SWL and URS groups were 0% and 6.7%, respectively (P=0.000).ConclusionCompared with SWL, URS had significantly higher stone-free rates in patients with proximal ureteral stones. Treatment costs and hospital stay were lower in the SWL group, whereas complication rates were comparable.
Highlights
Urolithiasis is the most common worldwide cause of morbidity in patients with diseases of the urinary tract [1]
150 patients presenting with proximal ureteral stones at the Department of Urology of Nishter Hospital Multan from November 2018 to November 2019 were allocated 1:1 to undergo Ureteroscopic pneumatic lithotripsy (URS) or shock wave lithotripsy (SWL)
Rates of stone retropulsion into the kidneys in the SWL and URS groups were 0% and 6.7%, respectively (P=0.000)
Summary
Urolithiasis is the most common worldwide cause of morbidity in patients with diseases of the urinary tract [1]. Invasive procedures have eased the removal of urinary tract stones [2]. Ureteral stones were previously managed by open ureter lithotomy, newer techniques, including shock wave lithotripsy (SWL), refinement of semirigid ureter scopes, flexible ureterorenoscopy, and certain laparoscopic procedures have been shown safe and effective in the treatment of ureteral stones, in adults and children [35]. SWL is a minimally invasive technique that can be performed on an outpatient basis for the treatment of proximal ureteral calculi [6]. Ureteroscopic pneumatic lithotripsy (URS) treatment is another technique increasingly used to remove ureteral calculi, especially distal calculi [8]. The success rate of semirigid URS was shown to be higher for proximal than for distal stones [9]. Because URS is associated with a higher success rate after a single session and a lower rate of multiple visits, URS is preferred to SWL in areas in which healthcare facilities are limited
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
