Ibrahim, M., Hasaan, A., Helmy, A. (2018). Comparison between the Efficacy of Transureteral Lithotripsy and Extracorporeal Shock Wave Lithotripsy in the Treatment of Distal Ureteral Stone. The Egyptian Journal of Hospital Medicine, 70(10), 1778-1783.
Mahmoud Ezzat Ibrahim; Ahmed Tawfik Hasaan; Ahmed Mohamed Helmy. "Comparison between the Efficacy of Transureteral Lithotripsy and Extracorporeal Shock Wave Lithotripsy in the Treatment of Distal Ureteral Stone". The Egyptian Journal of Hospital Medicine, 70, 10, 2018, 1778-1783.
Ibrahim, M., Hasaan, A., Helmy, A. (2018). 'Comparison between the Efficacy of Transureteral Lithotripsy and Extracorporeal Shock Wave Lithotripsy in the Treatment of Distal Ureteral Stone', The Egyptian Journal of Hospital Medicine, 70(10), pp. 1778-1783.
Ibrahim, M., Hasaan, A., Helmy, A. Comparison between the Efficacy of Transureteral Lithotripsy and Extracorporeal Shock Wave Lithotripsy in the Treatment of Distal Ureteral Stone. The Egyptian Journal of Hospital Medicine, 2018; 70(10): 1778-1783.
Comparison between the Efficacy of Transureteral Lithotripsy and Extracorporeal Shock Wave Lithotripsy in the Treatment of Distal Ureteral Stone
Department of Urology, Faculty of Medicine, Ain Shams University.
Abstract
Objective: To compare the efficacy, cost effect and safety of extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy (URS) for distal ureteric calculi by evaluating stone-free rates, retreatment rates, need for auxiliary procedures, associated complications and technical consideration with respect to patient satisfaction. Patient and method: 70 patients with single unilateral radiopaque distal ureteric stone ranges from 0.8 cm to 1.2 cm in diameter and ≥1.5 cm in length were enrolled in a prospective randomized trial. Patients were randomized to undergo URS (35) or ESWL (35). The electromagnetic Dornier lithotripter S was used for ESWL and a semi-rigid Olympus ureteroscope, 7° direction of view, angled ocular,8.6/9.8 Fr. x 43 cm, 6.4 Fr. channel was used for URS. Patient and stone characteristics, treatment parameters, clinical outcomes, and patient satisfaction were assessed for each group. Results: Patients in the ESWL group achieved a 77.1% overall stone-free rate (SFR) with a 74.3% retreatment rate and no auxiliary procedure was done. Complications occurred in 11.4% of patients treated with ESWL. Patients in the URS group achieved a 97.1% overall SFR with a retreatment rate of 8.6% and an auxiliary procedure rate of 100%. Complications occurred in 31.4% of patients treated with URS. Patient satisfaction was high for both groups, including 94.3% for URS and 77.1% for ESWL. ESWL were already at outpatient clinic so there were no admissions or hospital stay. While in URS group patients admitted with mean hospital stay 1.6±0.5 day. Conclusions: In the treatment of large distal ureteral calculi ≥ 1.5 cm, both URS and ESWL modalities are comparable but URS is recommended as a first option as it is more effective than ESWL regarding stone-free rate and it provides immediate stone clearance with lower retreatment rates and higher patient satisfaction.
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