Bağcı U. et al., 2023: Comparing the efficacy of extracorporeal shock wave lithotripsy and ureteroscopic lithotripsy in the treatment of proximal ureteral stones in children: A retrospective study
Bağcı U, Dinçkal M, Tekin A, Kızılay F, Nazlı O, Ulman İ.
Department of Pediatric Urology, Faculty of Medicine, Ege University, Izmir, Turkey.
Department of Urology, Faculty of Medicine, Ege University, Izmir, Turkey.
Abstract
Objectives: Ureteroscopic lithotripsy and extracorporeal shock wave lithotripsy methods are commonly used in the treatment of proximal ureteral stones. There are no adequate studies showing which method is more effective in children. In our study, we aimed to evaluate and compare the efficacy of two treatment methods, commonly used for proximal ureteral stones in children.
Methods: A total of 78 patients who underwent ureteroscopic lithotripsy (n = 38) and extracorporeal shock wave lithotripsy (n = 40) due to stones located in the proximal ureter between 2010 and 2021 were included in the study. Demographic data, clinical characteristics, and treatment outcomes were retrospectively analyzed. Kolmogorov-Smirnov, Chi-square, and Mann-Whitney U tests were used for statistical analysis.
Results: There was no statistical difference between the demographic characteristics of the groups, except for the mean age values (p = 0.008). A statistically significant difference was found in favor of the extracorporeal shock wave lithotripsy group in terms of stone-free rates after the first intervention, complication rates requiring intervention, re-intervention rates, and the average number of anesthesia sessions per patient until stone-free status (p = 0.043, p = 0.009, p = 0.017, and p < 0.001, respectively).
Conclusions: The results of this retrospective study suggest that extracorporeal shock wave lithotripsy is the primary treatment option for single, non-complicated proximal ureteral stones.
Int J Urol. 2023 Jul 11. doi: 10.1111/iju.15245. Online ahead of print.PMID: 37431807
Comments 1
Another simple retrospective study on a well known topic with not essentially new information. However reading it makes you feel good, comfortable and like you are in the hands of responsible surgeons.
I liked the sincere way they concluded based on their own experience and performance: “According to the results of our study, when we make a decision on ESWL treatment for a pediatric patient presenting with a non-complicated, single proximal ureteral stone, the patient will need re-intervention at a rate of 13% and will receive an average of 1 anesthesia session. On the other hand, when we make a decision of URSL treatment under the same conditions, we predict that 37% of the patient will need re-intervention and will receive an average of 2.3 anesthesia sessions. These results clearly show that ESWL treatment of proximal ureteral stones requires less anesthesis sessions with less re-interventions compared to URSL.”
There is room for improvement of their URS skills : -))
Peter Alken