Treatment of Upper and Mid Ureter Stones: Comparison of Semirigid Ureteroscopic Lithotripsy with Holmium: YAG Laser and Shock Wave Lithotripsy

Yong Uk Kwon; Sang Ik Lee; Tae Yoong Jeong

doi:10.4111/kju.2007.48.2.171

Journal List > Korean J Urol > v.48(2) > 1004857

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kwon, Lee, and Jeong: Treatment of Upper and Mid Ureter Stones: Comparison of Semirigid Ureteroscopic Lithotripsy with Holmium: YAG Laser and Shock Wave Lithotripsy

Original Article

Korean Journal of Urology

Korean Journal of Urology 2007; 48(2): 171-175.

Published online: 28 February 2007

DOI: https://doi.org/10.4111/kju.2007.48.2.171

Treatment of Upper and Mid Ureter Stones: Comparison of Semirigid Ureteroscopic Lithotripsy with Holmium: YAG Laser and Shock Wave Lithotripsy

Yong Uk Kwon, Sang Ik Lee, Tae Yoong Jeong

Department of Urology, College of Medicine, Kwandong University, Goyang, Korea.

Corresponding author (urojeong@kwandong.ac.kr)

Received 24 August 2006 Accepted 4 January 2007

Abstract

Purpose

To compare the success rates, complications and cost effectiveness of extracorporeal shock wave lithotripsy (ESWL) and ureteroscopic lithotripsy (URS) using a Holmium: YAG laser to establish the more effective treatment for upper and mid ureter stones.

Materials and Methods

This retrospective study included 83 and 286 patients treated with URS and ESWL, respectively, for upper and mid ureter stones. URS was performed with a 7.5Fr semi-rigid ureterorenoscope and Holmium: YAG laser. ESWL was performed with Stonelith V.5 (PCK, Turkey). The stone sizes, success rates, postoperative complications and cost effectiveness were analyzed for each group.

Results

The overall success rates of the URS and ESWL were 97.6 and 82.5%, respectively. Success rates of URS were 98.4 and 95.2% when the stones were smaller and larger than 10mm, respectively. In the ESWL group, the success rates after the third session were 86.3 and 65.4% with stones smaller and larger than 10mm, respectively. The complication rates associated with URS and ESWL were 6 and 4.2%, respectively. The average cost of URS was lower than that of ESWL.

Conclusions

In our study, URS with Holmium: YAG laser was more efficacious than ESWL. Considering both the success rate and cost effectiveness, URS should remain the recommended first-line treatment for upper and mid ureter stones.

Keywords: Ureter stone, Extracorporeal shockwave lithotripsy, Ureteroscopy, Holmium

Figures and Tables

Table 1

The characteristics of the patients and stones

URS: ureteroscopic removal of stone, ESWL: extracorporeal shock wave lithotripsy

Table 2

Success rates of URS and ESWL for upper and mid ureter stones

URS: ureteroscopic removal of stone, ESWL: extracorporeal shock wave lithotripsy, ^*: success rate of URS was higher than ESWL (p<0.05)

Table 3

Complications of URS and ESWL

URS: ureteroscopic removal of stone, ESWL: extracorporeal shock wave lithotripsy, ^*: complication rate of URS and ESWL were not significant difference (p>0.05).

References

1. Chaussy C, Schmiedt E, Jocham D, Brendel W, Forssmann B, Walther V. First clinical experience with extracorporeally induced destruction of kidney stones by shock waves. J Urol. 1982. 127:417–420.

2. Perez-Castro EE, Martinez-Pineiro JA. Transurethral ureteroscopy. A current urological procedure. Arch Esp Urol. 1980. 33:445–460.

3. Jenkins AD, Gillenwater JY. Extracorporeal shock wave lithotripsy in the prone position: treatment of stones in the distal ureter or anomalous kidney. J Urol. 1988. 139:911–915.

4. Chaussy CG, Fuchs GJ. Current state and future developments of noninvasive treatment of human urinary stones with extracorporeal shock wave lithotripsy. J Urol. 1989. 141:782–789.

5. Grasso M, Beaghler M, Loisides P. The case for primary endoscopic management of upper urinary tract calculi. II: cost and outcome assessment of 112 primary ureteral calculi. Urology. 1994. 45:372–376.

6. Netto Junior NR, Claro JF, Lemos GC, Cortado PL. Treatment options for ureteral calculi: endourology or extracorporeal shock wave lithotripsy. J Urol. 1991. 146:5–7.

7. Erhard M, Salwen J, Bagley DH. Ureteroscopic removal of mid and proximal ureteral calculi. J Urol. 1996. 155:38–42.

8. Kramolowsky EV. Complications of ureteroscopy. Semin Urol. 1989. 7:39–42.

9. Byeon SS, Jeon SS, Lee HW, Park EC, Lee JH, Kwak C, et al. Ureteroscopic manipulation for ureteral calculi: comparison with ESWL. Korean J Urol. 1996. 37:1125–1129.

10. Wu CF, Chen CS, Lin WY, Shee JJ, Lin CL, Chen Y, et al. Therapeutic options for proximal ureter stone: extracorporeal shock wave lithotripsy versus semirigid ureterorenoscope with holmium: yttrium-aluminum-garnet laser lithotripsy. Urology. 2005. 65:1075–1079.

11. Teichman JM, Rao RD, Rogenes VJ, Harris JM. Ureteroscopic management of ureteral calculi: electrohydraulic versus holmium: YAG lithotripsy. J Urol. 1997. 158:1357–1361.

12. Singal R, Denstedt JD. Contemporary management of ureteral stones. Urol Clin North Am. 1997. 24:59–70.

13. Anderson KR, Keetch DW, Albala DM, Chandhoke PS, Mc-Clennan BL, Clayman RV. Optimal therapy for the distal ureteral stone: extracorporeal shock wave lithotripsy versus ureteroscopy. J Urol. 1994. 152:62–65.

14. Benjamin JC, Donaldson PJ, Hill JT. Ureteral perforation after ureteroscopy. Conservative management. Urology. 1987. 29:623–624.

15. Dretler SP. Management of the lower ureteral stone. AUA Update Series. 1995. 14:62–67.

16. Turk TM, Jenkins AD. A comparison of ureteroscopy to in situ extracorporeal shock wave litotripsy for the treatment of distal ureteral calculi. J Urol. 1999. 161:45–47.

17. Kwon MH, Noh JH, Kim SI. Comparison of ureteroscopic lithotripsy and extracorporeal shock wave lithotripsy in the treatment of upper ureteral stones. Korean J Urol. 2003. 44:633–636.

18. Lingeman JE, Shirrell WL, Newman DM, Mosbaugh PG, Steele RE, Woods JR. Management of upper ureteral calculi with extracorporeal shock wave lithotripsy. J Urol. 1987. 138:720–723.

19. Bierkens AF, Hendrikx AJ, De La Rosette JJ, Stultiens GN, Beerlage HP, Arends AJ, et al. Treatment of mid- and low ureteric calculi: extracorporeal shock-wave lithotripsy vs laser ureteroscopy. A comparison of costs, morbidity and effectiveness. Br J Urol. 1998. 81:31–35.

20. Kapoor DA, Leech JE, Yap WT, Rose JF, Kabler R, Mowad JJ. Cost and efficacy of extracorporeal shock wave lithotripsy versus ureteroscopy in the treatment of lower ureteral calculi. J Urol. 1992. 148:1095–1096.

TOOLS

Similar articles