Comparison of Ureteroscopic Lithotripsy and Extracoporeal Shock Wave Lithotripsy in the Treatment of Upper Ureteral Stones

Kwon, Myung Hoon; Noh, Joon Hwa; Kim, Sang Ik

Abstract

PURPOSE: Cases of ureteroscopic lithotripsy (URS) were retrospectively reviewed to define the efficacy of an ureteroscopic lithotripsy in the treatment of upper ureteral stones. The success rates, reasons for failure and complications of URS were compared with extracoporeal shock wave lithotripsy (ESWL).
MATERIALS AND METHODS
URS for upper ureteral stones was performed in 48 cases, between January, 2000 and December, 2002. A 7.5Fr, or 9.5Fr, rigid ureteroscopy and stone basket were used with, or without, electrohydraulic lithotripsy. There were 29 males and 19 females, with a mean age of 43.3 years.
RESULTS
The overall success rate of the URS was 91.6%. According to the stone size, the success rates were 92.1 and 90% in stones smaller than 10mm and larger than 10mm, respectively. With the ESWL treatments, the overall stone free rate was 71.7% with only one session. The stone free rate was significantly affected by the size, was and were 77.9 and 46.3% in stones smaller than 10mm and larger than 10mm, respectively. The stone free rate after the second and third ESWL sessions were 81.3 and 91.3%, respectively. The associated complication rate for URS was 18.1%, with the complications consisting of ureteral mucosal injuries in 3 patient, flank pain (>48 hours) in 2, a ureteral perforation in 1, fever in 1 and a gross hematuria (>48 hours) in 1, which were all treated successfully with conservative treatment.
CONCLUSIONS
URS can be a successful and safe treatment modality for upper ureteral stones, even if larger than 10mm.