1829 LASER LITHOTRIPSY VERSUS ESWL FOR LOWER CALYCEAL RENAL STONES

Abstract

You have accessJournal of UrologyStone Disease: SWL, Ureteroscopy or Percutaneous Stone Removal (III)1 Apr 20131829 LASER LITHOTRIPSY VERSUS ESWL FOR LOWER CALYCEAL RENAL STONES Ahmed Salem, Ismail Saad, Ashraf Emran, Mahmoud Abdelhakiem, Omar Abdelrazzak, and Mongy Abdelkader Ahmed SalemAhmed Salem Cairo, Egypt , Ismail SaadIsmail Saad Cairo, Egypt , Ashraf EmranAshraf Emran Cairo, Egypt , Mahmoud AbdelhakiemMahmoud Abdelhakiem Cairo, Egypt , Omar AbdelrazzakOmar Abdelrazzak Cairo, Egypt , and Mongy AbdelkaderMongy Abdelkader Cairo, Egypt View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2192AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urolithiasis, especially lower calyceal (LC) stones, is a common medical problem. Its prevalence is around 2% to 3 % in general population. With advances of endourologic and laser technology, flexible ureterorenoscopy (FURS) and laser lithotripsy (LL) are considered the second line therapy in ESWL-resistent LC stones. This study aimed to assess safety, efficacy and outcome of FURS and holmium:YAG LL comparing its results to ESWL in LC stones. METHODS A prospective randomized study was done from May 2010 to May 2012. It included patients with radiopaque unilateral, single or multiple, LC ≤ 20mm. Patients were divided into 2 groups. In Group I, patients underwent FURS and LL using 365 μm laser fiber. In Group II, patients underwent ESWL. Patients were followed for 3 months by KUB to assess stone-free status defined as no fragments or fragment ≤ 3mm. In each group, multiple parameters (age, sex, stone size and number, and LC anatomy) were examined to assess impact on stone-free status. Additionally stone-free status and complications were compared in both groups. RESULTS 60 patients were included in the study. In Group I (N=30), mean age was 44.2 years and mean stone size was 11.5mm. 26 patients (86.7%) had single stone and 4 patients (13.3%) had multiple stones. Stone free status was achieved in 29 patients (96.7%). Complication rate was 16.7%. Age, sex, stone size and number, and LC anatomy did not correlate with stone-free status in Group I. In Group II (N=30), mean age was 35.5 years and mean stone size was 11.3mm. 28 patients (93.3%) had single stone and 2 patients (6.7%) had multiple stones. Stone-free status was achieved in 17 patients (56.7%). Complication rate was 23.3%. Stone size (<10mm) only correlated with stone-free status in Group II. FURS and LL achieved significantly better stone-free rates compared to ESWL (96.7% vs 56.7%, p= 0.001), with no difference in complication rate between both groups (16.7% vs 23.3%, p= 0.5). CONCLUSIONS Both FURS with LL and ESWL are considered safe in treating LC stones less than 20mm with minimal complication rates. However, FURS with LL achieved significantly better stone-free rates. Stone size could predict stone-free status in ESWL. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byKallidonis P, Ntasiotis P, Somani B, Adamou C, Emiliani E, Knoll T, Skolarikos A and Tailly T (2020) Systematic Review and Meta-Analysis Comparing Percutaneous Nephrolithotomy, Retrograde Intrarenal Surgery and Shock Wave Lithotripsy for Lower Pole Renal Stones Less Than 2 cm in Maximum DiameterJournal of Urology, VOL. 204, NO. 3, (427-433), Online publication date: 1-Sep-2020. Volume 189Issue 4SApril 2013Page: e751 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Metrics Author Information Ahmed Salem Cairo, Egypt More articles by this author Ismail Saad Cairo, Egypt More articles by this author Ashraf Emran Cairo, Egypt More articles by this author Mahmoud Abdelhakiem Cairo, Egypt More articles by this author Omar Abdelrazzak Cairo, Egypt More articles by this author Mongy Abdelkader Cairo, Egypt More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...