Cargando…

Comparison of Shock Wave Lithotripsy and Flexible Ureterorenoscopy in the Treatment of 10–20 mm Lower Pole Stone: Prospective Non-randomized Study

Introduction: The objective of the study is to clarify the efficiency, safety, and limitations of shock wave lithotripsy (SWL) and flexible ureterorenoscopy (f-URS) in the management of lower pole stones (LPS). Methods: The present study was planned prospectively in a non-randomized manner. Patients...

Descripción completa

Detalles Bibliográficos
Autor principal: Kezer, Cem
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9834605/
https://www.ncbi.nlm.nih.gov/pubmed/36644093
http://dx.doi.org/10.7759/cureus.32452
_version_ 1784868498535612416
author Kezer, Cem
author_facet Kezer, Cem
author_sort Kezer, Cem
collection PubMed
description Introduction: The objective of the study is to clarify the efficiency, safety, and limitations of shock wave lithotripsy (SWL) and flexible ureterorenoscopy (f-URS) in the management of lower pole stones (LPS). Methods: The present study was planned prospectively in a non-randomized manner. Patients who had LPS between 10 and 20 cm in size were enrolled in the study. Patient demographic characteristics, stone-related parameters, complications, and success were noted. Patients who underwent SWL and patients who underwent f-URS were compared according to demographic characteristics, procedure-related parameters, complications, and success rate. Results: A total of 82 patients matched the study inclusion criteria, with 44 patients treated with SWL and 38 patients treated with f-URS. The time between diagnosis and the end of the treatment was 29.2 days in the SWL group and 15.2 days in the f-URS group (p = 0.001). The success rate was 89.5% with f-URS and 72.7% with SWL (p = 0.036). Receiver operating curve analysis revealed that a stone size larger than 14 mm in the lower pole was significantly associated with SWL failure (area under the curve [AUC]: 0.711, p = 0.033), and a stone size larger than 16 mm was a predictive factor for f-URS failure. Conclusion: The present study found that f-URS had a significantly higher stone-free rate in the management of 10-20 mm LPS compared to SWL. For the first time, this study showed that the time between diagnosis and the end of treatment was significantly shorter with f-URS. Moreover, LPS larger than 14 mm and 16 mm were predictive factors for SWL and f-URS failure, respectively.
format Online
Article
Text
id pubmed-9834605
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-98346052023-01-12 Comparison of Shock Wave Lithotripsy and Flexible Ureterorenoscopy in the Treatment of 10–20 mm Lower Pole Stone: Prospective Non-randomized Study Kezer, Cem Cureus Urology Introduction: The objective of the study is to clarify the efficiency, safety, and limitations of shock wave lithotripsy (SWL) and flexible ureterorenoscopy (f-URS) in the management of lower pole stones (LPS). Methods: The present study was planned prospectively in a non-randomized manner. Patients who had LPS between 10 and 20 cm in size were enrolled in the study. Patient demographic characteristics, stone-related parameters, complications, and success were noted. Patients who underwent SWL and patients who underwent f-URS were compared according to demographic characteristics, procedure-related parameters, complications, and success rate. Results: A total of 82 patients matched the study inclusion criteria, with 44 patients treated with SWL and 38 patients treated with f-URS. The time between diagnosis and the end of the treatment was 29.2 days in the SWL group and 15.2 days in the f-URS group (p = 0.001). The success rate was 89.5% with f-URS and 72.7% with SWL (p = 0.036). Receiver operating curve analysis revealed that a stone size larger than 14 mm in the lower pole was significantly associated with SWL failure (area under the curve [AUC]: 0.711, p = 0.033), and a stone size larger than 16 mm was a predictive factor for f-URS failure. Conclusion: The present study found that f-URS had a significantly higher stone-free rate in the management of 10-20 mm LPS compared to SWL. For the first time, this study showed that the time between diagnosis and the end of treatment was significantly shorter with f-URS. Moreover, LPS larger than 14 mm and 16 mm were predictive factors for SWL and f-URS failure, respectively. Cureus 2022-12-12 /pmc/articles/PMC9834605/ /pubmed/36644093 http://dx.doi.org/10.7759/cureus.32452 Text en Copyright © 2022, Kezer et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Urology
Kezer, Cem
Comparison of Shock Wave Lithotripsy and Flexible Ureterorenoscopy in the Treatment of 10–20 mm Lower Pole Stone: Prospective Non-randomized Study
title Comparison of Shock Wave Lithotripsy and Flexible Ureterorenoscopy in the Treatment of 10–20 mm Lower Pole Stone: Prospective Non-randomized Study
title_full Comparison of Shock Wave Lithotripsy and Flexible Ureterorenoscopy in the Treatment of 10–20 mm Lower Pole Stone: Prospective Non-randomized Study
title_fullStr Comparison of Shock Wave Lithotripsy and Flexible Ureterorenoscopy in the Treatment of 10–20 mm Lower Pole Stone: Prospective Non-randomized Study
title_full_unstemmed Comparison of Shock Wave Lithotripsy and Flexible Ureterorenoscopy in the Treatment of 10–20 mm Lower Pole Stone: Prospective Non-randomized Study
title_short Comparison of Shock Wave Lithotripsy and Flexible Ureterorenoscopy in the Treatment of 10–20 mm Lower Pole Stone: Prospective Non-randomized Study
title_sort comparison of shock wave lithotripsy and flexible ureterorenoscopy in the treatment of 10–20 mm lower pole stone: prospective non-randomized study
topic Urology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9834605/
https://www.ncbi.nlm.nih.gov/pubmed/36644093
http://dx.doi.org/10.7759/cureus.32452
work_keys_str_mv AT kezercem comparisonofshockwavelithotripsyandflexibleureterorenoscopyinthetreatmentof1020mmlowerpolestoneprospectivenonrandomizedstudy