Impact of previous SWL on ureterorenoscopy outcomes and optimal timing for ureterorenoscopy after SWL failure in proximal ureteral stones

İrer, Bora; Mo, Sahin; Erbatu, Oğuzcan; Yildiz, Alperen; Ongün, Şakir; Çınar, Önder; Cíhan, Ahmet; Şahin, Mehmet Oğuz; Şen,; Üçer, Oktay; Kızılay, Fuat; Bozkurt, Ozan

doi:10.1007/s00345-019-02809-4

Cited by 8 publications

(23 citation statements)

References 23 publications

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“…However, only proximal and distal-ureteral small stones were investigated in their studies. In Bora et al study [24], the mean proximal ureteral stone burden was 83.7 ± 57.2 mm 2 and complication rates were signi cantly higher in patients with previous SWL. The results of this study similarly showed that the complication rates of URS treatment were signi cantly higher in patients who suffered SWL treatment failure for proximal stones 10 mm.…”

Section: Discussionmentioning

confidence: 86%

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Comparison of Ureteroscopy (URS) Complementary Treatment after Extracorporeal Shock Wave Lithotripsy Failure with Primary URS Lithotripsy with Holmium Laser Treatment for Proximal Ureteral Stones Larger than 10mm

Feng¹,

Jiang²,

Xie³

et al. 2021

Preprint

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Background: To compare ureteroscopy (URS) complementary treatment following extracorporeal shock wave lithotripsy (SWL) failure with primary URS lithotripsy for proximal ureteral stones ＞ 10 mm, and try to find out optimal SWL session followed by safe URS.Methods: This was a retrospective study following approval from Medical Ethics Committee of People's Hospital of Chongqing Banan District. Patients (n=340) who received URS in our hospital for stones ＞10 mm from Jan 2015 to June 2020 were divided into two groups according to their previous SWL history. Group 1 consisted of 160 patients that underwent unsuccessful SWL before URS. Group 2 encompassed 180 patients without SWL before URS. Patient’s operative outcomes were compared. Receiver operator characteristics were used to identify the optimal SWL session, regarding the intra-operative complications of URS.Results: The group 1 required more surgery time (41.38 ± 11.39 min vs. 36.43 ± 13.36 min, P=0.01). At the same time, more intra-operative (68.1% VS 22.8%, p = 0.000) and post-operative (35% VS 18.0%, p = 0.001) complications occurred in group 1. Need more hospital stay in group 1 (2.7 ± 1.2 days vs 1.6 ± 1.1 days, p < 0.05). More patients in group 1 need further URS (16.3% VS 6.7%, p = 0.004). After second URS, the SFR of URS was insignificant differences (82.5% VS 88.9%, p＞ 0.05). The median (25% - 75%) of SWL sessions before URS was 2(1-3) in group 1. The optimal SWL session followed by URS were 0.5 (Area Under Curve = 0.718, p ＜ 0.001) with a sensitivity of 67.7% and specificity of 71.5%. Intra-operative complication rates of URS treatment were higher in patients who suffered ＞ 1 SWL failure (72.6% vs 57.4%, p = 0.047).Conclusion: There was no optimal SWL session that could be followed by URS with fewer intra-operative complications. Patients who underwent previous SWL were likely to suffer more intra-operative complications, the average operating time, hospitalization time, and needing further treatment, during URS treatment for proximal ureteral stones larger than 10 mm.

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Section: Discussionmentioning

confidence: 86%

“…treatment. To get lower complications, it was suggested that URS procedures should be delayed 2-3 weeks after unsuccessful SWL [24].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Ureteroscopy (URS) Complementary Treatment after Extracorporeal Shock Wave Lithotripsy Failure with Primary URS Lithotripsy with Holmium Laser Treatment for Proximal Ureteral Stones Larger than 10mm

Feng¹,

Jiang²,

Xie³

et al. 2021

Preprint

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“…[ 4 ] In addition, MPCNL or RPLU may be considered as an alternative when SWL or URS is not indicated or failed. [ 5 ] Our previous study has shown that RPLU could provide better SFR than URS for impacted upper ureteral stones greater than 12 mm. [ 6 ]…”

Section: Introductionmentioning

confidence: 99%

Comparison of mini-percutaneous nephrolithotomy and retroperitoneal laparoscopic ureterolithotomy for treatment of impacted proximal ureteral stones greater than 15 mm

Wang¹,

Huang²,

Zhao³

et al. 2021

Chinese Medical Journal

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Background: The optimal treatment for large impacted proximal ureteral stones remains controversial. The aim of this study was to evaluate the efficacy, safety, and potential complications of mini-percutaneous nephrolithotomy (MPCNL) and retroperitoneal laparoscopic ureterolithotomy (RPLU) in the treatment of impacted proximal ureteral stones with size greater than 15 mm. Methods: A total of 268 patients with impacted proximal ureteral stones greater than 15 mm who received MPCNL or RPLU procedures were enrolled consecutively between January 2014 and January 2019. Data on surgical outcomes and complications were collected and analyzed. Results: Demographic and ureteral stone characteristics found between these two groups were not significantly different. The surgical success rate (139/142, 97.9% vs. 121/126, 96.0%, P = 0.595) and stone-free rate after 1 month (139/142, 97.9% vs. 119/126, 94.4%, P = 0.245) of RPLU group were marginally higher than that of the MPCNL group, but there was no significant difference. There was no significant difference in the drop of hemoglobin between the two groups (0.8 ± 0.6 vs. 0.4 ± 0. 2 g/dL, P = 0.621). The mean operative time (68.2 ± 12.5 vs. 87.2 ± 16.8 min, P = 0.041), post-operative analgesics usage (2/121, 1.7% vs. 13/139, 9.4%, P = 0.017), length of hospital stay after surgery (2.2 ± 0.6 vs. 4.8 ± 0.9 days, P < 0.001), double J stent time (3.2 ± 0.5 vs . 3.9 ± 0.8 days, P = 0.027), time of catheterization (1.1 ± 0.3 vs. 3.5 ± 0.5 days, P < 0.001), and time of drainage tube (2.3 ± 0.3 vs . 4.6 ± 0.6 days, P < 0.001) of MPCNL group were significantly shorter than that of the RPLU group. The complication rate was similar between the two groups (20/121, 16.5% vs . 31/139, 22.3%, P = 0.242). Conclusions: MPCNL and RPLU have similar surgical success and stone clearance in treating impacted proximal ureteral stones greater than 15 mm, while patients undergoing MPCNL had a lower post-operative pain rate and a faster recovery.

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“…In clinical practice, URS is often employed as salvage therapy in SWL-resistant stones. However, only a few studies (7)(8)(9)(10)(11)(12)(13) have determined the impact of previous unsuccessful SWL on the outcomes of URS with conflicting results. Holland et al reported that URS was associated with a lower SFR and higher complication rate when performed after unsuccessful SWL (7).…”

Section: Introductionmentioning

confidence: 99%

“…Holland et al reported that URS was associated with a lower SFR and higher complication rate when performed after unsuccessful SWL (7). Irer et al also demonstrated that complications were significantly higher in patients with a previous SWL (8). In contrast, several studies showed that previous failed SWL had no impact on the SFR and complications of URS (9)(10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Does previous unsuccessful shockwave lithotripsy influence the outcomes of ureteroscopy?—a systematic review and meta-analysis

Wang¹,

Liao²,

Di³

et al. 2021

Transl Androl Urol

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Impact of previous SWL on ureterorenoscopy outcomes and optimal timing for ureterorenoscopy after SWL failure in proximal ureteral stones

Cited by 8 publications

References 23 publications

Comparison of Ureteroscopy (URS) Complementary Treatment after Extracorporeal Shock Wave Lithotripsy Failure with Primary URS Lithotripsy with Holmium Laser Treatment for Proximal Ureteral Stones Larger than 10mm

Comparison of Ureteroscopy (URS) Complementary Treatment after Extracorporeal Shock Wave Lithotripsy Failure with Primary URS Lithotripsy with Holmium Laser Treatment for Proximal Ureteral Stones Larger than 10mm

Comparison of mini-percutaneous nephrolithotomy and retroperitoneal laparoscopic ureterolithotomy for treatment of impacted proximal ureteral stones greater than 15 mm

Does previous unsuccessful shockwave lithotripsy influence the outcomes of ureteroscopy?—a systematic review and meta-analysis

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