Korean J Urol.  2010 Nov;51(11):788-793.

Comparison of Patient Satisfaction with Treatment Outcomes between Ureteroscopy and Shock Wave Lithotripsy for Proximal Ureteral Stones

• Lee JH
• Woo SH
• Kim ET
• Kim DK
• Park J

Abstract

PURPOSE
We examined patient satisfaction with treatment outcomes after shock wave lithotripsy (SWL) and ureteroscopic removal of stone (URS) for proximal ureteral stones.
MATERIALS AND METHODS
We evaluated 224 consecutive patients who underwent SWL (n=156) or URS (n=68) for a single radiopaque proximal ureteral stone. Stone-free rates, defined as no visible fragment on a plain X-ray; complications; and patient satisfaction were compared. Patient satisfaction was examined through a specifically tailored questionnaire that included overall satisfaction (5 scales) and 4 domains (pain, voiding symptoms, cost, and stone-free status).
RESULTS
The stone-free rates after the first, second, and third sessions of SWL were 36.5%, 65.4%, and 84.6%, respectively. The overall stone-free rate of URS was 82.4%, which was comparable to that of the third session of SWL. Complications were similar between the two groups except for greater steinstrasse in the SWL group. Overall satisfaction and voiding symptoms, cost, and stone-free status showed no significant difference between the groups. In the pain domain, the SWL group had a relatively lower satisfaction rate than did the URS group (p=0.05). Subanalysis showed that the satisfaction rate of the URS group with stone-free status was significantly lower than that of the SWL group in patients with > or =10 mm stones (p=0.032).
CONCLUSIONS
Overall treatment outcomes and patient satisfaction were not significantly different between SWL and URS. However, patients undergoing URS for > or =10 mm proximal ureteral stones had lesser satisfaction with stone-free status, because of relatively lower stone-free rates due to upward stone migration. We suggest that factors regarding the subjective satisfaction of patients be included in counseling about treatment options for proximal ureteral stones.

Keyword

Lithotripsy; Patient satisfaction; Ureteral calculi; Ureteroscopy

MeSH Terms

Counseling
Humans
Lithotripsy
Patient Satisfaction
Shock
Ureter
Ureteral Calculi
Ureteroscopy

Figure

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  FIG. 1 Overall satisfaction according to treatment method. SWL: shock wave lithotripsy, URS: ureteroscopic removal of stone.

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  FIG. 2 Overall satisfaction in patients with <10 mm (A) and ≥10 mm proximal ureteral stones (B). SWL: shock wave lithotripsy, URS: ureteroscopic removal of stone.

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