Effectiveness of Emergency Ureterorenoscopic Lithotripsy for Distal Ureter Stones

Abstract

Purpose: We performed this study to determine the efficacy between the use of emergency ureterorenoscopic lithotripsy (URSL) and emergency shock wave lithotripsy (SWL) for distal ureter stones in terms of stone-free rates, complication rates and patient satisfaction. Materials and Methods: This prospective study included 145 patients with distal ureter stones who underwent emergency URSL (URSL group, n=64) and emergency SWL (SWL group, n=81). All emergency URSL and SWL procedures were performed within eight hours of admission. Stone status was evaluated with either an intravenous pyelogram or the use of nonenhanced CT. URSL was performed with 7.5 Fr semi-rigid ureterorenosope and SWL was performed with Sonolith PRACTIS V.5.0 (EDAP TECHNOMED). The stone-free rates, complication rates, visual analogue pain scale and patient satisfaction scores were analyzed for each group of patients. Results: The overall stone-free rates of the URSL and SWL group of patients at two weeks were 96.8% and 74%, respectively (p=0.001). Complication rates were similar (28.1% versus 27.1%, p=0.897). The patient satisfaction score was statistically significant in favor of patients that underwent emergency URSL. Conclusions: In our single-center study, treatment with emergency URSL provided higher stone-free rates and superior patient satisfaction, as compared with treatment with emergency SWL. Emergency URSL was considered as attractive modality for the management of distal ureter stones. (Korean J Urol 2008;49:257-261) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏