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Prospective randomized trial comparing shock wave lithotripsy and ureteroscopic lithotripsy for management of large upper third ureteral stones.
Urology. 2006 Mar; 67(3):480-4; discussion 484.U

Abstract

OBJECTIVES

To conduct a prospective and randomized trial to compare the efficiency quotient and cost-effectiveness index of shock wave lithotripsy (SWL) and ureteroscopic lithotripsy (URSL) for the treatment of large upper third ureteral stones.

METHODS

A total of 35 male patients and 7 female patients with a solitary, radiopaque upper ureteral stone, 15 mm or more in diameter, who underwent SWL or URSL were enrolled in this study. The mean patient age was 53.1 +/- 14.5 years. The endpoint of the study was for the patient to be stone free or to have insignificant residual stone (3 mm or less) within the kidney.

RESULTS

The mean stone length +/- SD was 17.9 +/- 3.9 cm in the SWL group and 18.5 +/- 2.9 cm in the URSL group (P > 0.05). The efficiency quotient for SWL and URSL was 0.61 and 0.63, respectively. The cost-effectiveness index, treatment time, pain score, and hospital stay were greater in the URSL group. However, the degree of hydronephrosis significantly influenced the success rate of SWL. All patients with severe hydronephrosis in the SWL group needed auxiliary surgical procedures to become stone free.

CONCLUSIONS

The efficiency quotients of SWL and URSL were comparable in the treatment of large upper third ureteral stones. However, SWL should not be recommended as the first-line treatment option for the management of upper third ureteral stones larger than 1.5 cm with severe hydronephrosis. Understanding the cost-effectiveness, success rate, pain score, and patient satisfaction score for the two different approaches constitutes the indispensable requisites for choosing the optimal first-line therapeutic strategy.

Authors+Show Affiliations

Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan, Republic of China. yhlee@mail.chimei.org.twNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16527562

Citation

Lee, Ying-Huei, et al. "Prospective Randomized Trial Comparing Shock Wave Lithotripsy and Ureteroscopic Lithotripsy for Management of Large Upper Third Ureteral Stones." Urology, vol. 67, no. 3, 2006, pp. 480-4; discussion 484.
Lee YH, Tsai JY, Jiaan BP, et al. Prospective randomized trial comparing shock wave lithotripsy and ureteroscopic lithotripsy for management of large upper third ureteral stones. Urology. 2006;67(3):480-4; discussion 484.
Lee, Y. H., Tsai, J. Y., Jiaan, B. P., Wu, T., & Yu, C. C. (2006). Prospective randomized trial comparing shock wave lithotripsy and ureteroscopic lithotripsy for management of large upper third ureteral stones. Urology, 67(3), 480-4; discussion 484.
Lee YH, et al. Prospective Randomized Trial Comparing Shock Wave Lithotripsy and Ureteroscopic Lithotripsy for Management of Large Upper Third Ureteral Stones. Urology. 2006;67(3):480-4; discussion 484. PubMed PMID: 16527562.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective randomized trial comparing shock wave lithotripsy and ureteroscopic lithotripsy for management of large upper third ureteral stones. AU - Lee,Ying-Huei, AU - Tsai,Jeng-Yu, AU - Jiaan,Bang-Ping, AU - Wu,Tony, AU - Yu,Chia-Chen, PY - 2005/06/29/received PY - 2005/08/08/revised PY - 2005/09/08/accepted PY - 2006/3/11/pubmed PY - 2006/4/28/medline PY - 2006/3/11/entrez SP - 480-4; discussion 484 JF - Urology JO - Urology VL - 67 IS - 3 N2 - OBJECTIVES: To conduct a prospective and randomized trial to compare the efficiency quotient and cost-effectiveness index of shock wave lithotripsy (SWL) and ureteroscopic lithotripsy (URSL) for the treatment of large upper third ureteral stones. METHODS: A total of 35 male patients and 7 female patients with a solitary, radiopaque upper ureteral stone, 15 mm or more in diameter, who underwent SWL or URSL were enrolled in this study. The mean patient age was 53.1 +/- 14.5 years. The endpoint of the study was for the patient to be stone free or to have insignificant residual stone (3 mm or less) within the kidney. RESULTS: The mean stone length +/- SD was 17.9 +/- 3.9 cm in the SWL group and 18.5 +/- 2.9 cm in the URSL group (P > 0.05). The efficiency quotient for SWL and URSL was 0.61 and 0.63, respectively. The cost-effectiveness index, treatment time, pain score, and hospital stay were greater in the URSL group. However, the degree of hydronephrosis significantly influenced the success rate of SWL. All patients with severe hydronephrosis in the SWL group needed auxiliary surgical procedures to become stone free. CONCLUSIONS: The efficiency quotients of SWL and URSL were comparable in the treatment of large upper third ureteral stones. However, SWL should not be recommended as the first-line treatment option for the management of upper third ureteral stones larger than 1.5 cm with severe hydronephrosis. Understanding the cost-effectiveness, success rate, pain score, and patient satisfaction score for the two different approaches constitutes the indispensable requisites for choosing the optimal first-line therapeutic strategy. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/16527562/Prospective_randomized_trial_comparing_shock_wave_lithotripsy_and_ureteroscopic_lithotripsy_for_management_of_large_upper_third_ureteral_stones_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(06)00070-7 DB - PRIME DP - Unbound Medicine ER -