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Extracorporeal shock-wave lithotripsy or ureteroscopy as primary treatment for ureteric stones: a retrospective study comparing two different treatment strategies.
Scand J Urol Nephrol. 2006; 40(2):113-8.SJ

Abstract

OBJECTIVE

Our extracorporeal shock-wave lithotripsy (ESWL) lithotripter with ultrasound localization technique was replaced in 1999 by a Storz SLX-MX lithotripter with both X-ray and ultrasound detection possibilities. Before replacing our lithotripter, most ureteric stones were treated with ureteroscopy (URS); subsequently, almost all patients underwent ESWL as primary treatment. The aim of this retrospective study was to compare the results of these two treatment strategies in all consecutive patients attending our hospital in 1998 and 2000 for ureteric stone treatment.

MATERIAL AND METHODS

The medical records of all patients treated for ureteric stones in 1998 and 2000 were reviewed. In 1998, 173 ureteric stones were treated. Primary treatment was URS in 124 patients, push back/ESWL in 24, ESWL in 21 and open surgery in four. In 2000, 176 ureteric stones were treated: 158 with ESWL and 18 with URS. ESWL or URS monotherapy was defined as ESWL or URS, respectively as the only stone-treatment therapy, with or without the use of a ureteric catheter or nephrostomy tube. Treatment success was defined as a stone-free ureter.

RESULTS

In 1998, the success rate for URS monotherapy was 95%, with a retreatment rate (sessions per stone situation) of 1.06. Corresponding figures for ESWL monotherapy in 2000 were 90% and 1.69. All URS patients received general anaesthesia; ESWL patients received opiods. Complication rates were 6% for URS and 3% for ESWL. In the URS group, 4/8 complications were considered to be major.

CONCLUSION

ESWL should be considered the first-line treatment for ureteric stones because of its non-invasive nature, lack of a requirement for general anaesthesia and low complication rates.

Authors+Show Affiliations

Department of Urology, Sahlgrenska University Hospital, Göteborg, Sweden. klas.lindqvist@vgregion.seNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16608808

Citation

Lindqvist, Klas, et al. "Extracorporeal Shock-wave Lithotripsy or Ureteroscopy as Primary Treatment for Ureteric Stones: a Retrospective Study Comparing Two Different Treatment Strategies." Scandinavian Journal of Urology and Nephrology, vol. 40, no. 2, 2006, pp. 113-8.
Lindqvist K, Holmberg G, Peeker R, et al. Extracorporeal shock-wave lithotripsy or ureteroscopy as primary treatment for ureteric stones: a retrospective study comparing two different treatment strategies. Scand J Urol Nephrol. 2006;40(2):113-8.
Lindqvist, K., Holmberg, G., Peeker, R., & Grenabo, L. (2006). Extracorporeal shock-wave lithotripsy or ureteroscopy as primary treatment for ureteric stones: a retrospective study comparing two different treatment strategies. Scandinavian Journal of Urology and Nephrology, 40(2), 113-8.
Lindqvist K, et al. Extracorporeal Shock-wave Lithotripsy or Ureteroscopy as Primary Treatment for Ureteric Stones: a Retrospective Study Comparing Two Different Treatment Strategies. Scand J Urol Nephrol. 2006;40(2):113-8. PubMed PMID: 16608808.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Extracorporeal shock-wave lithotripsy or ureteroscopy as primary treatment for ureteric stones: a retrospective study comparing two different treatment strategies. AU - Lindqvist,Klas, AU - Holmberg,Göran, AU - Peeker,Ralph, AU - Grenabo,Lars, PY - 2006/4/13/pubmed PY - 2006/10/6/medline PY - 2006/4/13/entrez SP - 113 EP - 8 JF - Scandinavian journal of urology and nephrology JO - Scand J Urol Nephrol VL - 40 IS - 2 N2 - OBJECTIVE: Our extracorporeal shock-wave lithotripsy (ESWL) lithotripter with ultrasound localization technique was replaced in 1999 by a Storz SLX-MX lithotripter with both X-ray and ultrasound detection possibilities. Before replacing our lithotripter, most ureteric stones were treated with ureteroscopy (URS); subsequently, almost all patients underwent ESWL as primary treatment. The aim of this retrospective study was to compare the results of these two treatment strategies in all consecutive patients attending our hospital in 1998 and 2000 for ureteric stone treatment. MATERIAL AND METHODS: The medical records of all patients treated for ureteric stones in 1998 and 2000 were reviewed. In 1998, 173 ureteric stones were treated. Primary treatment was URS in 124 patients, push back/ESWL in 24, ESWL in 21 and open surgery in four. In 2000, 176 ureteric stones were treated: 158 with ESWL and 18 with URS. ESWL or URS monotherapy was defined as ESWL or URS, respectively as the only stone-treatment therapy, with or without the use of a ureteric catheter or nephrostomy tube. Treatment success was defined as a stone-free ureter. RESULTS: In 1998, the success rate for URS monotherapy was 95%, with a retreatment rate (sessions per stone situation) of 1.06. Corresponding figures for ESWL monotherapy in 2000 were 90% and 1.69. All URS patients received general anaesthesia; ESWL patients received opiods. Complication rates were 6% for URS and 3% for ESWL. In the URS group, 4/8 complications were considered to be major. CONCLUSION: ESWL should be considered the first-line treatment for ureteric stones because of its non-invasive nature, lack of a requirement for general anaesthesia and low complication rates. SN - 0036-5599 UR - https://www.unboundmedicine.com/medline/citation/16608808/Extracorporeal_shock_wave_lithotripsy_or_ureteroscopy_as_primary_treatment_for_ureteric_stones:_a_retrospective_study_comparing_two_different_treatment_strategies_ L2 - https://www.tandfonline.com/doi/full/10.1080/00365590410028683 DB - PRIME DP - Unbound Medicine ER -