ABSTRACT
Background: In the last decade different minimally invasive modalities for management of urolithiasis have been available requiring an intelligent decision by the urologist to choose one as per patients need and preferences.Methods: The present cross sectional study was conducted among patients who underwent ureterorenoscopic lithotripsy for proximal ureteric stones in the Department of Urology. Using consecutive sampling technique, patients were randomly allocated to two groups for treatment with either pneumatic lithotripser (group A) or Holmium laser lithotripser for fragmentation of calculi (group B) and the comparison of both these techniques was done.Results: 117 patients were included (57 and 60 in group A and group B respectively) in the study. The difference in age in the two groups was found to be statistically significant (p=0.03). The total operative time, length of stay in hospital and complications were more in group A patients. The difference in two groups for total operative time and length of stay in hospital was statistically significant (p=0.00 and 0.00 respectively).Conclusions: Holmium laser lithotripser has better safety profile when compared to pneumatic lithotripser especially in stone clearance rate and retropulsion rates and could be used as modality of choice in proximal ureteric stones.
ABSTRACT
PURPOSE: We performed this study to determine the efficacy between the use of emergency ureterorenoscopic lithotripsy(URSL) and emergency shock wave lithotripsy(SWL) for distal ureter stones in terms of stone-free rates, complication rates and patient satisfaction. MATERIALS AND METHODS: This prospective study included 145 patients with distal ureter stones who underwent emergency URSL(URSL group, n=64) and emergency SWL(SWL group, n=81). All emergency URSL and SWL procedures were performed within eight hours of admission. Stone status was evaluated with either an intravenous pyelogram or the use of non- enhanced CT. URSL was performed with 7.5 Fr semi-rigid ureterorenosope and SWL was performed with Sonolith PRACTIS V.5.0(EDAP TECHNOMED). The stone-free rates, complication rates, visual analogue pain scale and patient satisfaction scores were analyzed for each group of patients. RESULTS: The overall stone-free rates of the URSL and SWL group of patients at two weeks were 96.8% and 74%, respectively(p=0.001). Complication rates were similar(28.1% versus 27.1%, p=0.897). The patient satisfaction score was statistically significant in favor of patients that underwent emergency URSL. CONCLUSIONS: In our single-center study, treatment with emergency URSL provided higher stone-free rates and superior patient satisfaction, as compared with treatment with emergency SWL. Emergency URSL was considered as attractive modality for the management of distal ureter stones.