Miniperc vs Shockwave Lithotripsy for Average-Sized, Radiopaque Lower Pole Calculi: A Prospective Randomized Study.

Abstract

Introduction: To detect safety and feasibility of miniperc and extracorporeal shockwave lithotripsy (SWL) for treatment of average-sized (1-2 cm), radiopaque lower pole calculi in a prospective randomized manner. Patients and Methods: In the period from January 2014 to June 2015, 150 patients were attached to this study with single lower pole radiopaque stone ranging from 10 to 20 mm. Patients were divided randomly into two groups using computer-generated randomization in an equal manner. First group patients were subjected to miniperc procedure, while second group patients underwent SWL. Patient's characters, stones' characters, fluoroscopic time, operative time, blood transfusion, hospital stay, retreatment, auxiliary procedure (AP), and complications using modified Clavien grading are tabulated and analyzed. Results: This study included two equal groups with 75 patients in each group. With regard to age (37.75 ± 11.25 vs 40.55 ± 10.55), body mass index (26.92 ± 2.26 vs 27.29 ± 2.87), and stone size (1.55 ± 0.28 vs 1.57 ± 0.26), there was no significant statistical difference in both groups. Stone-free rate (SFR) (76% vs 96%), operative time (44.81 ± 7.06 vs 93.37 ± 12.29 minutes), fluoroscopy time (53 ± 2.45 vs 180 ± 7.31 seconds), hospital stay (5.72 ± 1.01 vs 45.19 ± 8.48 hour), and blood transfusion were significantly more in the miniperc group. Retreatment rate (45.3% vs 2.7%) and AP (24% vs 4%) were significantly greater in the SWL group. Conclusion: SWL is less invasive than percutaneous stone removal, but it is also less effective for lower pole radiopaque calculi. Miniperc has better SFR and lower auxiliary and retreatment rates; however, it resulted in more drawbacks.