Extracorporeal Shock Wave Lithotripsy versus Ureteroscopy Lithoclast in Management of Upper Ureteric Stones

Abstract

Objective: To compare the efficacy of Extracorporeal Shock Wave Lithotripsy (ESWL) with URS Lithoclast in management of upper Ureteric stones

Study Design: Retrospective study

Place and Duration of Study: This study was conducted at the Department of Urology, Sahiwal Teaching Hospital, Sahiwal, from June, 2021 to January, 2022 for a period of eight months.

Materials and Methods: Two groups were formed of total 70 patients. In the group undergoing ureterorenoscopy surgery was done by giving general anesthesia. Swiss pneumatic lithoclast, 0.8 mm or 1 mm probe, was used to break down the stone. SWL was performed on all patients using the standard procedure using Storz Modulith SLX-MX electromagnetic lithotripter equipment (3rd generation). A shock wave was delivered to the patient every 60 seconds until the desired result was achieved. If the stone was > 1.5 cm, a double J stent was typically used. The procedure was performed by a consultant doctor who specializes in the ESWL machine.

Results: Stone-free rate after first and second session in SWL was lower than URS group, but the difference was not statistically significant. The mean procedure time of SWL and URS was 65.88±2.05 and 87.98±9.22, respectively, (p=0.000). The mean number of sessions and hospital stay in both the groups was almost equal, (p≥0.050). The clavien grading system was applied to examine the complications in both the groups.

Conclusion: It can be concluded that stone free rate of proximal Ureteric stones after single session of ESWL and URS showed significantly better outcome in URS group of patients