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Kim, Sung, and Noh: Comparison between Rigid Ureteroscopic Stone Removal (URS) and Extracorporeal Shock Wave Lithotripsy (ESWL) for Large (>10mm) Upper Ureteral Stones
Original Article
Korean Journal of Urology

Korean Journal of Urology 2006; 47(9): 933-937.

Published online: 30 September 2006

DOI: https://doi.org/10.4111/kju.2006.47.9.933

Comparison between Rigid Ureteroscopic Stone Removal (URS) and Extracorporeal Shock Wave Lithotripsy (ESWL) for Large (>10mm) Upper Ureteral Stones

Ji Hoon Kim, Luck Hee Sung, Choong Hee Noh

Department of Urology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.

Corresponding author (uroman1@yahoo.com)

Received 4 May 2006       Accepted 12 July 2006

Copyright © 2006 The Korean Urological Association

Abstract

Purpose

The aim of this study was to compare the efficacy, safety and compliance of ureteroscopic stone removal (URS) patients who were treated with extracorporeal shock wave lithotripsy (ESWL) for large (>10mm) proximal ureteral stones.

Materials and Methods

We reviewed 123 patients who were treated for upper ureteral stones (>10mm) between January 2000 and March 2005. URS and ESWL were performed in 51 and 72 patients, respectively. Success was defined as the patients achieving a stone-free status on radiography at 1 month after treatment. We analyzed the success rates of stone removal, the reasons for failure and the complication rates of each procedure.

Results

The overall success rate of URS was 90.2%. For the ESWL treatments, the overall success rates after the first, second, third and more sessions were 47.2%, 61.1%, 76.4% and 81.9%, respectively. Notably, the stone free rate of the URS group was better than that of the 1st, 2nd and 3rd session ESWL group (p<0.05). The complication rate of URS was 24.0% and that of ESWL was 22.2%; the difference was not statistically significant (p<0.05).

Conclusions

In this study, URS achieved an excellent stone free rate and a similar complication rate to that of ESWL for treating large (>10mm) upper ureteral calculi. Thus, this procedure should be considered as first line therapy for large (>10mm) upper ureteral stones. In addition, for the proper selection of patients for ESWL and URS, analysis of the cost effectiveness, compliance and recurrence rates of the two groups should be done in the future.

Keywords: Ureteral calculi, Ureteroscopes, Extracorporeal shockwave lithotripsy

Figures and Tables

Table 1
Characteristics of the patients
kju-47-933-i001

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

Table 2
Success rates of URS (%) and ESWL (%) for >1cm upper ureteral stone according to the stone size (mm)
kju-47-933-i002

URS: ureteroscopic removal of stone, ESWL: extracorporeal shock wave lithotripsy, *: p<0.05

Table 3
Complications of URS and ESWL
kju-47-933-i003

URS: ureteroscopic removal of stone, ESWL: extracorporeal shock wave lithotripsy, *: p>0.05

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