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Shock wave lithotripsy versus semirigid ureteroscopy for proximal ureteral calculi (<20 mm): a comparative matched-pair study.
Urology. 2009 Jun; 73(6):1184-7.U

Abstract

OBJECTIVES

To use a matched-pair analysis design to compare the safety and efficacy of shock wave lithotripsy (SWL) and ureteroscopy (URS). Controversy still exists regarding whether SWL or URS is the best management of upper ureteral calculi.

METHODS

We reviewed the records of patients with a single radiopaque upper ureteral stone treated by URS or SWL from January 2003 to December 2005. SWL was performed as an outpatient procedure using the electromagnetic lithotripter (Dornier Lithotripter S). URS was performed using an 8F or 8.5F semirigid ureteroscope. Intracorporeal lithotripsy with pneumatic or holmium laser energy was used when needed. A matched-pair analysis was performed using 3 parameters (sex, stone size, and degree of hydronephrosis). The success rates, retreatment rates, auxiliary procedures, and complications were compared in each group.

RESULTS

A total of 427 patients were treated for upper ureteral stones. Forty-three matched pairs were identified and compared. The success rate was 83.7% for SWL vs 88.4% for URS (P = .8). The retreatment rate was significantly greater in the SWL group than in the URS group (65% vs 2.3%, respectively; P < .001). The need for auxiliary procedures was equal in both groups (16.3%). The complication rate was 14% in the URS group and 4.7% in the SWL group (P = .1).

CONCLUSIONS

SWL and semirigid URS are highly effective in the treatment of proximal ureteral stones <20 mm. The results of our study showed that SWL was safer and less invasive, but that URS was more effective and resulted in a lower retreatment rate.

Authors+Show Affiliations

Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19362338

Citation

Youssef, Ramy F., et al. "Shock Wave Lithotripsy Versus Semirigid Ureteroscopy for Proximal Ureteral Calculi (<20 Mm): a Comparative Matched-pair Study." Urology, vol. 73, no. 6, 2009, pp. 1184-7.
Youssef RF, El-Nahas AR, El-Assmy AM, et al. Shock wave lithotripsy versus semirigid ureteroscopy for proximal ureteral calculi (<20 mm): a comparative matched-pair study. Urology. 2009;73(6):1184-7.
Youssef, R. F., El-Nahas, A. R., El-Assmy, A. M., El-Tabey, N. A., El-Hefnawy, A. S., Eraky, I., El-Kenawy, M. R., El-Kappany, H. A., & Sheir, K. Z. (2009). Shock wave lithotripsy versus semirigid ureteroscopy for proximal ureteral calculi (<20 mm): a comparative matched-pair study. Urology, 73(6), 1184-7. https://doi.org/10.1016/j.urology.2008.12.064
Youssef RF, et al. Shock Wave Lithotripsy Versus Semirigid Ureteroscopy for Proximal Ureteral Calculi (<20 Mm): a Comparative Matched-pair Study. Urology. 2009;73(6):1184-7. PubMed PMID: 19362338.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Shock wave lithotripsy versus semirigid ureteroscopy for proximal ureteral calculi (<20 mm): a comparative matched-pair study. AU - Youssef,Ramy F, AU - El-Nahas,Ahmed R, AU - El-Assmy,Ahmed M, AU - El-Tabey,Nasr A, AU - El-Hefnawy,Ahmed S, AU - Eraky,Ibrahim, AU - El-Kenawy,Mahmoud R, AU - El-Kappany,Hamdy A, AU - Sheir,Khaled Z, Y1 - 2009/04/10/ PY - 2008/08/05/received PY - 2008/12/04/revised PY - 2008/12/30/accepted PY - 2009/4/14/entrez PY - 2009/4/14/pubmed PY - 2009/7/2/medline SP - 1184 EP - 7 JF - Urology JO - Urology VL - 73 IS - 6 N2 - OBJECTIVES: To use a matched-pair analysis design to compare the safety and efficacy of shock wave lithotripsy (SWL) and ureteroscopy (URS). Controversy still exists regarding whether SWL or URS is the best management of upper ureteral calculi. METHODS: We reviewed the records of patients with a single radiopaque upper ureteral stone treated by URS or SWL from January 2003 to December 2005. SWL was performed as an outpatient procedure using the electromagnetic lithotripter (Dornier Lithotripter S). URS was performed using an 8F or 8.5F semirigid ureteroscope. Intracorporeal lithotripsy with pneumatic or holmium laser energy was used when needed. A matched-pair analysis was performed using 3 parameters (sex, stone size, and degree of hydronephrosis). The success rates, retreatment rates, auxiliary procedures, and complications were compared in each group. RESULTS: A total of 427 patients were treated for upper ureteral stones. Forty-three matched pairs were identified and compared. The success rate was 83.7% for SWL vs 88.4% for URS (P = .8). The retreatment rate was significantly greater in the SWL group than in the URS group (65% vs 2.3%, respectively; P < .001). The need for auxiliary procedures was equal in both groups (16.3%). The complication rate was 14% in the URS group and 4.7% in the SWL group (P = .1). CONCLUSIONS: SWL and semirigid URS are highly effective in the treatment of proximal ureteral stones <20 mm. The results of our study showed that SWL was safer and less invasive, but that URS was more effective and resulted in a lower retreatment rate. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/19362338/Shock_wave_lithotripsy_versus_semirigid_ureteroscopy_for_proximal_ureteral_calculi__<20_mm_:_a_comparative_matched_pair_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(09)00130-7 DB - PRIME DP - Unbound Medicine ER -