Extra-corporeal shock wave lithotripsy (ESWL) versus ureteroscopic management for ureteric calculi

Aboumarzouk, Omar M.; Ahmad, Sarfraz; Kata, S.G.; Nabi, Ghulam

doi:10.1002/14651858.cd006029.pub2

Cited by 57 publications

(20 citation statements)

References 40 publications

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“…These excellent results achieved with late generation electromagnetic lithotriptors again seem to challenge the reference standard, that is the Dornier HM3. 1,2,25 Moreover, our 94% and 96% SFRs for nonstented proximal and distal ureteral stones 10 mm or less, respectively, challenge the SFR of holmium:YAG laser ureterorenoscopy, as demonstrated in our study in 543 patients. 26 Our results are compatible with those in the 2007 guidelines for managing ureteral calculi and matched pair analysis of URS vs SWL for proximal ureteral calculi.…”

Section: Ureteral Stonessupporting

confidence: 67%

Novel Electromagnetic Lithotriptor for Upper Tract Stones With and Without a Ureteral Stent

et al. 2009

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A high success rate and a low complication rate were achieved in renal and ureteral stone cases with and without prior ureteral stent placement. Total energy needed to achieve a stone-free state did not differ between stented and nonstented ureteral cases, suggesting the absence of a significant influence of the stent. Overall stents decreased complications necessitating hospitalization and auxiliary invasive measures.

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Section: Ureteral Stonessupporting

confidence: 67%

Novel Electromagnetic Lithotriptor for Upper Tract Stones With and Without a Ureteral Stent

et al. 2009

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“…Despite published Cochrane Reviews and clinical treatment guidelines there are no universally accepted paradigms to manage upper urinary tract calculi. 4,5 …”

mentioning

confidence: 99%

Treatment of Ureteral and Renal Stones: A Systematic Review and Meta-Analysis of Randomized, Controlled Trials

et al. 2012

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Purpose We compared the clinical outcomes of patients with ureteral or renal stones treated with ureteroscopy, shock wave lithotripsy using HM3 (Dornier®) and nonHM3 lithotripters, and percutaneous nephrolithotomy. Materials and Methods A systematic literature search identified 6, 4 and 3 randomized, controlled trials of treatment of distal and proximal ureteral stones, and renal stones, respectively, published between 1995 and 2010. Overall stone-free, re-treatment and complication rates were calculated by meta-analytical techniques. Results Based on the randomized, controlled trials evaluated the treatment of distal ureteral stones with semirigid ureteroscopy showed a 55% greater probability (pooled RR 1.55, 95% CI 1.13–2.56) of stone-free status at the initial assessment than treatment with shock wave lithotripsy. Patients treated with semirigid ureteroscopy were also less likely to require re-treatment than those treated with shock wave lithotripsy (nonHM3) (RR 0.14, 95% CI 0.08–0.23). The risk of complications was no different between the 2 modalities. Only 2 of the 4 randomized, controlled trials identified for proximal ureteral stones evaluated flexible ureteroscopy and each focused specifically on the treatment of stones 1.5 cm or greater, limiting their clinical relevance. The degree of heterogeneity among the studies evaluating renal stones was so great that it precluded any meaningful comparison. Conclusions Semirigid ureteroscopy is more efficacious than shock wave lithotripsy for distal ureteral stones. To our knowledge there are no relevant randomized, controlled trials of flexible ureteroscopy treatment of proximal ureteral calculi of a size commonly noted in the clinical setting. Collectively the comparative effectiveness of ureteroscopy and shock wave lithotripsy for proximal ureteral and renal calculi is poorly characterized with no meaningful published studies.

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“…For example, in a meta-analysis of five randomized control trials comparing SFRs of SWL versus URS, a higher SFR was found with URS compared to SWL although URS was associated with a higher complication rate. 8 These results do not apply to lower pole calculi, where the SFRs are largely equivalent between the techniques. 9 Achieving a high SFR utilizing URS typically requires general anesthesia, which in the morbidly obese is associated with higher associated risks, most commonly cardiorespiratory compromise.…”

Section: Introductionmentioning

confidence: 94%

A Multicenter Comparison of the Safety and Effectiveness of Ureteroscopic Laser Lithotripsy in Obese and Normal Weight Patients

Chew

Zavaglia

Paterson

et al. 2013

Journal of Endourology

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Extra-corporeal shock wave lithotripsy (ESWL) versus ureteroscopic management for ureteric calculi

Cited by 57 publications

References 40 publications

Novel Electromagnetic Lithotriptor for Upper Tract Stones With and Without a Ureteral Stent

Novel Electromagnetic Lithotriptor for Upper Tract Stones With and Without a Ureteral Stent

Treatment of Ureteral and Renal Stones: A Systematic Review and Meta-Analysis of Randomized, Controlled Trials

A Multicenter Comparison of the Safety and Effectiveness of Ureteroscopic Laser Lithotripsy in Obese and Normal Weight Patients

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