Prospective Randomized Trial Comparing Shock Wave Lithotripsy and Ureteroscopy for Management of Distal Ureteral Calculi

Pearle, Margaret S.; Nadler, Robert B.; Bercowsky, Eduardo; CHEN, CATHY; Dunn, Matt; Figenshau, R. Sherburne; Hoenig, David M.; McDougall, Elspeth M.; Mutz, Jackie; Nakada, Stephen Y.; Shalhav, Arieh L.; Sundaram, Chandru P.; Wolf, J. Stuart; Clayman, Ralph V.

doi:10.1097/00005392-200110000-00009

Cited by 36 publications

(56 citation statements)

References 22 publications

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“…Most of the comparative studies between ESWL and ureteroscopy are not conclusive and sometimes ambiguous. While some studies are in favor of ESWL [7], others concluded that ureteroscopy is the preferable approach [16]–[18]. We compared several objective outcomes of each procedure method, including stone clearance rate, treatment time, procedural time, complications and costs.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of ESWL and Ureteroscopic Holmium Laser lithotripsy in Management of Ureteral Stones

et al. 2014

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BackgroundThere are many options for urologists to treat ureteral stones that range from 8 mm to 15 mm, including ESWL and ureteroscopic holmium laser lithotripsy. While both ESWL and ureteroscopy are effective and minimally invasive procedures, there is still controversy over which one is more suitable for ureteral stones.ObjectiveTo perform a retrospective study to compare the efficiency, safety and complications using ESWL vs. ureteroscopic holmium laser lithotripsy in management of ureteral stones.MethodsBetween October 2010 and October 2012, 160 patients who underwent ESWL or ureteroscopic holmium laser lithotripsy at Suzhou municipal hospital for a single radiopaque ureteral stone (the size 8–15 mm) were evaluated. All patients were followed up with ultrasonography for six months. Stone clearance rate, costs and complications were compared.ResultsSimilarity in stone clearance rate and treatment time between the two procedures; overall procedural time, analgesia requirement and total cost were significantly different. Renal colic and gross hematuria were more frequent with ESWL while voiding symptoms were more frequent with ureteroscopy. Both procedures used for ureteral stones ranging from 8 to 15 mm were safe and minimally invasive.ConclusionESWL remains first line therapy for proximal ureteral stones while ureteroscopic holmium laser lithotripsy costs more. To determining which one is preferable depends on not only stone characteristics but also patient acceptance and cost-effectiveness ratio.

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Section: Discussionmentioning

confidence: 99%

“…Multiple sessions of ESWL resulted in a similar outcome to ureteroscopy. This could explain why the stone clearance rate of ESWL varied from 80%–100% [4], [7]. Furthermore, the stone clearance rate of ESWL was determined by stone composition and stone hardness.…”

Section: Discussionmentioning

confidence: 99%

Comparison of ESWL and Ureteroscopic Holmium Laser lithotripsy in Management of Ureteral Stones

et al. 2014

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“…Another notably observed point was that the success rate in the f irst session of lithotripsy was 89.5% and only 10.5% of subjects required additional sessions of treatment. In contrast, some previous studies have reported that successful treatment required more than a single-session lithotripsy (Pearl , 2001). Interestingly, a considerable number of our considered patients with the urinary calculi in the lower segment of their ureters.…”

Section: Resultsmentioning

confidence: 90%

“…Ghimire et al(2012) reported that the number of sessions needed for lithotripsy increased as the location of the stones moved from proximal part of the ureter to the distal part. Specif ically, 1.11 and 1.71 sessions were required for stones in the upper and lower ureter, respectively (Pearl et al, 2001). However, our study revealed the number of sessions were less and most of the patients responded to one session of lithotripsy only.…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal Shock Wave Lithotripsy for the treatment of ureteral stones : a Critique on Success rate

Barzegarnezhad¹,

Kerigh²,

Azizi³

2016

AMBIENT SCIENCE

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In nowadays Extracorporeal Shock Wave Lithotripsy (SWL) is one of the most accepted and minimally invasive therapeutic options for the treatment of urinary stones. Unfortunately, till date, only a handful studies have regarded the extrusion rate of stones located in the middle and lower part of the ureter via SWL. We evaluated the success rate of this procedure in the treatment of ureteral calculi by conducting a descriptive study carried out through the analysis of the f iles and radiographs of 191 patients with urolithiasis who underwent lithotripsy.. Success rates were recorded on the basis of the location of stones which were as follows: 89.4% with urolithiasis in the upper part of the ureter responded to one session of lithotripsy. The success rate in those with calculi located in the middle and the lower part of the ureter was 90.9% and 88.1%, respectively. Gross hematuria and pyelonephritis were observed in 90.05% and 2.61% of patients, respectively. AbstractIntroduction:

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“…Perchel ve ark. [28,29] Üreter taşlarının tedavisinde URS'de kullanılan farklı enerji kaynakları ile yüz güldürücü sonuçlar elde edilmiştir. Kara ve ark.…”

Section: Discussionunclassified

Our results of rigid ureteroscopy and pneumatic lithotripsy in patients with ureteral stones

Aslan¹,

Kirilmaz²,

Tuncel³

et al. 2010

Turkish Journal of Urology

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Objective:To determine the efficiency of rigid ureteroscopy and pneumatic lithotripsy in ureteral stones. Materials and methods:We retrospectively evaluated 349 patients (356 renal units) with ureteral stones treated with rigid ureteroscopy and pneumatic lithotripsy. Results were evaluated 3 months after treatment by using excretory urography and/or ultrasonography. Complications and treatment success according to stone localization were compared. Results:The mean age of the patients was 43.2 (range 17-80). Of the patients 236 (66.6%) were male and 113 (33.4%) were female. Of the stones 271 (76.1%) were localized to lower ureter, compared to middle ureter in 51 (14.3%) and upper ureter in 34 (9.6%). The mean stone diameter was 13.6 (range 5-30) mm. The mean stone free rate was 92.4% (79.4% in upper ureter, 94.1% in middle ureter and 93.7% in lower ureter, p=0.020). Overall complication rate was 7.6% (7.7% in lower ureter, 3.9% in middle ureter and 11.8% in upper ureter, p=0.413). Most common peroperative complications of the procedure were infection 2.6% (n=9), ureteral perforation 4% (n=14), and mucosal laceration 1.1% (n=4). The most common late complication was ureteral stricture in 1.1% (n=4) of patients. Patients with lower ureteral stone were divided into two groups according to stone size; Group 1 ≤10 mm (n=154) and Group 2 >10 mm (n=117). Although statistically insignificant, overall stone free rate (95.5% vs 91.5%, p= 0.178) was higher and complication rate (5.2% vs %11.1, p=0.071) was lower in Group 1. Conclusion:Ureteroscopic treatment of ureteral stones with pneumatic lithotripsy and rigid ureteroscopy applied in all localizations provides high success rates, quick stone clearance, short hospital stay, and low complication rates. In the lower ureteral localization, stone size does not affect the overall stone free and complication rates when treated with rigid ureteroscopy and pneumatic lithotripsy.

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Prospective Randomized Trial Comparing Shock Wave Lithotripsy and Ureteroscopy for Management of Distal Ureteral Calculi

Cited by 36 publications

References 22 publications

Comparison of ESWL and Ureteroscopic Holmium Laser lithotripsy in Management of Ureteral Stones

Comparison of ESWL and Ureteroscopic Holmium Laser lithotripsy in Management of Ureteral Stones

Extracorporeal Shock Wave Lithotripsy for the treatment of ureteral stones : a Critique on Success rate

Our results of rigid ureteroscopy and pneumatic lithotripsy in patients with ureteral stones

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