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A prospective, randomized comparison of shock wave lithotripsy, retrograde intrarenal surgery and miniperc for treatment of 1 to 2 cm radiolucent lower calyceal renal calculi: a single center experience.
J Urol 2015; 193(1):160-4JU

Abstract

PURPOSE

A prospective, randomized comparison of shock wave lithotripsy, retrograde intrarenal surgery and miniperc for the treatment of 1 to 2 cm radiolucent lower calyceal renal calculi was done to evaluate the safety and efficacy of these procedures.

MATERIALS AND METHODS

Patients with a single 1 to 2 cm radiolucent lower calyceal renal stone who underwent treatment between January 2012 and May 2013 were included in study. They were randomized to shock wave lithotripsy, retrograde intrarenal surgery and miniperc groups. Patient demographic profiles, success and re-treatment rates, auxiliary procedures and complications were analyzed.

RESULTS

A total of 45 patients were enrolled in each of the shock wave lithotripsy, retrograde intrarenal surgery and miniperc groups. Three, 2 and 4 patients, respectively, were excluded from final analysis due to a matrix stone diagnosis. Mean procedure and fluoroscopy times were significantly greater in the miniperc group than in the other groups. Hospital stay (3.1 days vs 3.1 hours and 1.3 days, p = 0.01) and the blood transfusion rate (13.3% vs 0% and 0%, p = 0.03) were significantly higher for miniperc vs shock wave lithotripsy and retrograde intrarenal surgery, respectively. The re-treatment rate (63.4% vs 2.1% and 2.2%, p <0.001) and the auxiliary procedure rate (20.2% vs 8.8% and 6.6%, p = 0.02) were significantly greater for shock wave lithotripsy than for retrograde intrarenal surgery and miniperc, respectively. The 3-month stone-free rate of shock wave lithotripsy, retrograde intrarenal surgery and miniperc was 73.8% (31 of 42 patients), 86.1% (37 of 43) and 95.1% (39 of 41), respectively (p = 0.01).

CONCLUSIONS

Miniperc and retrograde intrarenal surgery were more effective than shock wave lithotripsy to treat 1 to 2 cm radiolucent lower calyceal renal calculi in terms of a better stone-free rate, and lesser auxiliary and re-treatment rates. However, miniperc resulted in more complications, greater operative time and radiation exposure, and a longer hospital stay.

Authors+Show Affiliations

Department of Urology and Renal Transplant, V.M. Medical College and Safdarjang Hospital, New Delhi, India. Electronic address: anup_14k@yahoo.com.Department of Urology and Renal Transplant, V.M. Medical College and Safdarjang Hospital, New Delhi, India.Department of Urology and Renal Transplant, V.M. Medical College and Safdarjang Hospital, New Delhi, India.Department of Urology and Renal Transplant, V.M. Medical College and Safdarjang Hospital, New Delhi, India.Department of Urology and Renal Transplant, V.M. Medical College and Safdarjang Hospital, New Delhi, India.Department of Urology and Renal Transplant, V.M. Medical College and Safdarjang Hospital, New Delhi, India.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

25066869

Citation

Kumar, Anup, et al. "A Prospective, Randomized Comparison of Shock Wave Lithotripsy, Retrograde Intrarenal Surgery and Miniperc for Treatment of 1 to 2 Cm Radiolucent Lower Calyceal Renal Calculi: a Single Center Experience." The Journal of Urology, vol. 193, no. 1, 2015, pp. 160-4.
Kumar A, Kumar N, Vasudeva P, et al. A prospective, randomized comparison of shock wave lithotripsy, retrograde intrarenal surgery and miniperc for treatment of 1 to 2 cm radiolucent lower calyceal renal calculi: a single center experience. J Urol. 2015;193(1):160-4.
Kumar, A., Kumar, N., Vasudeva, P., Kumar Jha, S., Kumar, R., & Singh, H. (2015). A prospective, randomized comparison of shock wave lithotripsy, retrograde intrarenal surgery and miniperc for treatment of 1 to 2 cm radiolucent lower calyceal renal calculi: a single center experience. The Journal of Urology, 193(1), pp. 160-4. doi:10.1016/j.juro.2014.07.088.
Kumar A, et al. A Prospective, Randomized Comparison of Shock Wave Lithotripsy, Retrograde Intrarenal Surgery and Miniperc for Treatment of 1 to 2 Cm Radiolucent Lower Calyceal Renal Calculi: a Single Center Experience. J Urol. 2015;193(1):160-4. PubMed PMID: 25066869.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A prospective, randomized comparison of shock wave lithotripsy, retrograde intrarenal surgery and miniperc for treatment of 1 to 2 cm radiolucent lower calyceal renal calculi: a single center experience. AU - Kumar,Anup, AU - Kumar,Niraj, AU - Vasudeva,Pawan, AU - Kumar Jha,Sanjeev, AU - Kumar,Rohit, AU - Singh,Harbinder, Y1 - 2014/07/24/ PY - 2014/07/11/accepted PY - 2014/7/29/entrez PY - 2014/7/30/pubmed PY - 2015/4/4/medline KW - kidney KW - lithotripsy KW - nephrolithiasis KW - nephrostomy KW - operative KW - percutaneous KW - surgical procedures SP - 160 EP - 4 JF - The Journal of urology JO - J. Urol. VL - 193 IS - 1 N2 - PURPOSE: A prospective, randomized comparison of shock wave lithotripsy, retrograde intrarenal surgery and miniperc for the treatment of 1 to 2 cm radiolucent lower calyceal renal calculi was done to evaluate the safety and efficacy of these procedures. MATERIALS AND METHODS: Patients with a single 1 to 2 cm radiolucent lower calyceal renal stone who underwent treatment between January 2012 and May 2013 were included in study. They were randomized to shock wave lithotripsy, retrograde intrarenal surgery and miniperc groups. Patient demographic profiles, success and re-treatment rates, auxiliary procedures and complications were analyzed. RESULTS: A total of 45 patients were enrolled in each of the shock wave lithotripsy, retrograde intrarenal surgery and miniperc groups. Three, 2 and 4 patients, respectively, were excluded from final analysis due to a matrix stone diagnosis. Mean procedure and fluoroscopy times were significantly greater in the miniperc group than in the other groups. Hospital stay (3.1 days vs 3.1 hours and 1.3 days, p = 0.01) and the blood transfusion rate (13.3% vs 0% and 0%, p = 0.03) were significantly higher for miniperc vs shock wave lithotripsy and retrograde intrarenal surgery, respectively. The re-treatment rate (63.4% vs 2.1% and 2.2%, p <0.001) and the auxiliary procedure rate (20.2% vs 8.8% and 6.6%, p = 0.02) were significantly greater for shock wave lithotripsy than for retrograde intrarenal surgery and miniperc, respectively. The 3-month stone-free rate of shock wave lithotripsy, retrograde intrarenal surgery and miniperc was 73.8% (31 of 42 patients), 86.1% (37 of 43) and 95.1% (39 of 41), respectively (p = 0.01). CONCLUSIONS: Miniperc and retrograde intrarenal surgery were more effective than shock wave lithotripsy to treat 1 to 2 cm radiolucent lower calyceal renal calculi in terms of a better stone-free rate, and lesser auxiliary and re-treatment rates. However, miniperc resulted in more complications, greater operative time and radiation exposure, and a longer hospital stay. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/25066869/A_prospective_randomized_comparison_of_shock_wave_lithotripsy_retrograde_intrarenal_surgery_and_miniperc_for_treatment_of_1_to_2_cm_radiolucent_lower_calyceal_renal_calculi:_a_single_center_experience_ L2 - https://www.jurology.com/doi/full/10.1016/j.juro.2014.07.088?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -