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Flexible ureterorenoscopy versus extracorporeal shock wave lithotripsy for treatment of lower pole stones of 10-20 mm.
BJU Int. 2012 Sep; 110(6):898-902.BI

Abstract

What's known on the subject? and What does the study add? Shock wave lithotripsy and flexible ureterorenoscopy are acceptable treatment options for lower pole stones smaller than 10 mm, while percutaneous nephrolithotomy is the favoured treatment for stones larger than 20 mm. For treatment of lower pole stones of 10-20 mm, flexible ureterorenoscopy has a significantly higher stone-free rate and lower retreatment rate than shock wave lithotripsy.

OBJECTIVE

To compare the outcomes of flexible ureterorenoscopy (F-URS) and extracorporeal shock wave lithotripsy (ESWL) for treatment of lower pole stones of 10-20 mm.

PATIENTS AND METHODS

The database of patients with a single lower pole stone of 10-20 mm was examined to obtain two matched groups who were treated with F-URS or ESWL. Matching criteria were stone length, side and patient gender. Stone-free rates were evaluated 3 months after the last treatment session by non-contrast computed tomography. Both groups were compared for retreatment rate, complications and stone-free rate.

RESULTS

The matched groups included 37 patients who underwent F-URS and 62 patients who underwent ESWL. Retreatment rate was significantly higher for ESWL (60% vs 8%, P < 0.001). Complications were more after F-URS (13.5% vs 4.8%), but the difference was not significant (P= 0.146). All complications were grade II or IIIa on modified Clavien classification. The stone-free rate was significantly better after F-URS (86.5% vs 67.7%, P= 0.038). One failure of F-URS (2.7%) and five failures (8%) of ESWL were treated with percutaneous nephrolithotomy. Significant residual fragments in three patients (8%) after F-URS were treated with ESWL, while significant residual fragments after ESWL in five patients (8%) were treated with F-URS. Residual fragments (<4 mm) were followed every 3 months in one patient (2.7%) after F-URS and in 10 patients (16%) after ESWL.

CONCLUSIONS

For treatment of lower pole stones of 10-20 mm, F-URS provided significantly higher stone-free rate and lower retreatment rate compared with ESWL. The incidence of complications after F-URS was not significantly more than after ESWL.

Authors+Show Affiliations

Urology Department, Urology and Nephrology Center, Mansoura University, Egypt. ar_el_nahas@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22372915

Citation

El-Nahas, Ahmed R., et al. "Flexible Ureterorenoscopy Versus Extracorporeal Shock Wave Lithotripsy for Treatment of Lower Pole Stones of 10-20 Mm." BJU International, vol. 110, no. 6, 2012, pp. 898-902.
El-Nahas AR, Ibrahim HM, Youssef RF, et al. Flexible ureterorenoscopy versus extracorporeal shock wave lithotripsy for treatment of lower pole stones of 10-20 mm. BJU Int. 2012;110(6):898-902.
El-Nahas, A. R., Ibrahim, H. M., Youssef, R. F., & Sheir, K. Z. (2012). Flexible ureterorenoscopy versus extracorporeal shock wave lithotripsy for treatment of lower pole stones of 10-20 mm. BJU International, 110(6), 898-902. https://doi.org/10.1111/j.1464-410X.2012.10961.x
El-Nahas AR, et al. Flexible Ureterorenoscopy Versus Extracorporeal Shock Wave Lithotripsy for Treatment of Lower Pole Stones of 10-20 Mm. BJU Int. 2012;110(6):898-902. PubMed PMID: 22372915.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Flexible ureterorenoscopy versus extracorporeal shock wave lithotripsy for treatment of lower pole stones of 10-20 mm. AU - El-Nahas,Ahmed R, AU - Ibrahim,Hamdy M, AU - Youssef,Ramy F, AU - Sheir,Khaled Z, Y1 - 2012/02/28/ PY - 2012/3/1/entrez PY - 2012/3/1/pubmed PY - 2012/11/1/medline SP - 898 EP - 902 JF - BJU international JO - BJU Int. VL - 110 IS - 6 N2 - UNLABELLED: What's known on the subject? and What does the study add? Shock wave lithotripsy and flexible ureterorenoscopy are acceptable treatment options for lower pole stones smaller than 10 mm, while percutaneous nephrolithotomy is the favoured treatment for stones larger than 20 mm. For treatment of lower pole stones of 10-20 mm, flexible ureterorenoscopy has a significantly higher stone-free rate and lower retreatment rate than shock wave lithotripsy. OBJECTIVE: To compare the outcomes of flexible ureterorenoscopy (F-URS) and extracorporeal shock wave lithotripsy (ESWL) for treatment of lower pole stones of 10-20 mm. PATIENTS AND METHODS: The database of patients with a single lower pole stone of 10-20 mm was examined to obtain two matched groups who were treated with F-URS or ESWL. Matching criteria were stone length, side and patient gender. Stone-free rates were evaluated 3 months after the last treatment session by non-contrast computed tomography. Both groups were compared for retreatment rate, complications and stone-free rate. RESULTS: The matched groups included 37 patients who underwent F-URS and 62 patients who underwent ESWL. Retreatment rate was significantly higher for ESWL (60% vs 8%, P < 0.001). Complications were more after F-URS (13.5% vs 4.8%), but the difference was not significant (P= 0.146). All complications were grade II or IIIa on modified Clavien classification. The stone-free rate was significantly better after F-URS (86.5% vs 67.7%, P= 0.038). One failure of F-URS (2.7%) and five failures (8%) of ESWL were treated with percutaneous nephrolithotomy. Significant residual fragments in three patients (8%) after F-URS were treated with ESWL, while significant residual fragments after ESWL in five patients (8%) were treated with F-URS. Residual fragments (<4 mm) were followed every 3 months in one patient (2.7%) after F-URS and in 10 patients (16%) after ESWL. CONCLUSIONS: For treatment of lower pole stones of 10-20 mm, F-URS provided significantly higher stone-free rate and lower retreatment rate compared with ESWL. The incidence of complications after F-URS was not significantly more than after ESWL. SN - 1464-410X UR - https://www.unboundmedicine.com/medline/citation/22372915/Flexible_ureterorenoscopy_versus_extracorporeal_shock_wave_lithotripsy_for_treatment_of_lower_pole_stones_of_10_20_mm_ L2 - https://doi.org/10.1111/j.1464-410X.2012.10961.x DB - PRIME DP - Unbound Medicine ER -