Document Detail

Shock wave lithotripsy versus semirigid ureteroscopy for proximal ureteral calculi (<20 mm): a comparative matched-pair study.
MedLine Citation:
PMID:  19362338     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To use a matched-pair analysis design to compare the safety and efficacy of shock wave lithotripsy (SWL) and ureteroscopy (URS). Controversy still exists regarding whether SWL or URS is the best management of upper ureteral calculi. METHODS: We reviewed the records of patients with a single radiopaque upper ureteral stone treated by URS or SWL from January 2003 to December 2005. SWL was performed as an outpatient procedure using the electromagnetic lithotripter (Dornier Lithotripter S). URS was performed using an 8F or 8.5F semirigid ureteroscope. Intracorporeal lithotripsy with pneumatic or holmium laser energy was used when needed. A matched-pair analysis was performed using 3 parameters (sex, stone size, and degree of hydronephrosis). The success rates, retreatment rates, auxiliary procedures, and complications were compared in each group. RESULTS: A total of 427 patients were treated for upper ureteral stones. Forty-three matched pairs were identified and compared. The success rate was 83.7% for SWL vs 88.4% for URS (P = .8). The retreatment rate was significantly greater in the SWL group than in the URS group (65% vs 2.3%, respectively; P < .001). The need for auxiliary procedures was equal in both groups (16.3%). The complication rate was 14% in the URS group and 4.7% in the SWL group (P = .1). CONCLUSIONS: SWL and semirigid URS are highly effective in the treatment of proximal ureteral stones <20 mm. The results of our study showed that SWL was safer and less invasive, but that URS was more effective and resulted in a lower retreatment rate.
Ramy F Youssef; Ahmed R El-Nahas; Ahmed M El-Assmy; Nasr A El-Tabey; Ahmed S El-Hefnawy; Ibrahim Eraky; Mahmoud R El-Kenawy; Hamdy A El-Kappany; Khaled Z Sheir
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-04-10
Journal Detail:
Title:  Urology     Volume:  73     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-01     Completed Date:  2009-07-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1184-7     Citation Subset:  IM    
Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
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MeSH Terms
Equipment Design
Matched-Pair Analysis
Middle Aged
Ureteral Calculi / pathology,  therapy*
Comment In:
Urology. 2009 Jun;73(6):1188; author reply 1188   [PMID:  19482141 ]

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