Efficacy between ureteroscopic via urethral Peel-away sheath and transurethral ureteroscopy in treating bladder calculi:A comparative study / 中国内镜杂志

ABSTRACT

Objective To compare the effectiveness of ureteroscopic via urethral Peel-away sheath and transurethral ureteroscopy in treatment of bladder calculi. Methods Clinical data of 76 cases of bladder calculi patients were collected from January 2013 to December 2015. All the patients were randomly divided into two groups Group A was performed by ureteroscopic lithotripsy via urethral Peel-away sheath (n = 45). Group B was transurethral ureteroscopic lithotripsy (n = 31). Results 76 cases of bladder calculi were successfully treated by one-time lithotripsy. Lithotripsy time group A was (17.8 ± 5.9) min, group B was (22.7 ± 8.3) min (t = 2.96, P = 0.004); stone clearance time group A (12.6 ± 4.9) min, group B (24.5 ± 5.3) min (t = 9.90, P = 0.000);Intraoperative urethral mucosa injury group A (1.0 ± 0.5), group B (2.1 ± 0.4) (t = 9.47, P = 0.000); VAS scoregroup A (1.9 ± 0.6), group B (2.6 ± 0.6) points (t = 4.72, P = 0.000); indwelling catheter time group A (1.0 ± 0.2) d, B group (1.4 ± 0.9) d (t = 2.59, P = 0.012); There was no significant difference in hospitalization expense, group A was (7437.4 ± 356.7), group B was (7296.8 ± 333.8) (t = -1.73, P = 0.087). There were no complications such as hemorrhage, perforation and rupture of the 2 groups, without convertion to open surgery either. After the treatment of oral antibiotic, 1 case of postoperative urinary tract infection was cured in group B. In our study, case of postoperative urinary retention was 1 in group A, versus 5 in group B, with statistical difference (χ2 = 6.43, P = 0.011). Follow up 13 patients were lost to follow-up, the other patients were followed up for 6 ~ 12 months. There was 1 case of elderly male patient with urinary retention due to BPH in each of the 2 groups, the other patients had no recurrence of calculus. By analyzing the statistical results, it was found that the experimental group had obvious advantages over the control group in the lithotripsy time, stone clearance time, urethral mucosa injury, postoperative pain and postoperative indwelling catheter time. Conclusion There is no significant difference in efficacy of the treatment of bladder calculi between ureteroscopic via urethral Peel-away sheath and transurethral ureteroscopy. However, our study shows the Peel-away ureteroscopy has the advantages of shorter lithotripsy time, shorter time of stone clearance and less injury of urethra mucosa menbrane, there was no significant difference in operation cost between two groups. Therefore, Ureteroscopic via urethral Peel-away sheath is an effective method for endoscopic bladder lithotripsy.