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01-12-2017 | Original Article

A prospective randomized comparison among SWL, PCNL and RIRS for lower calyceal stones less than 2 cm: a multicenter experience

A better understanding on the treatment options for lower pole stones

Authors: G. Bozzini, P. Verze, D. Arcaniolo, O. Dal Piaz, N. M. Buffi, G. Guazzoni, M. Provenzano, B. Osmolorskij, F. Sanguedolce, E. Montanari, N. Macchione, K. Pummer, V. Mirone, M. De Sio, G. Taverna

Published in: World Journal of Urology | Issue 12/2017

Abstract

Purpose

To prospectively evaluate the efficacy and safety of RIRS, SWL and PCNL for lower calyceal stones sized 1–2 cm.

Materials and methods

Patients with a single lower calyceal stone with an evidence of a CT diameter between 1 and 2 cm were enrolled in this multicenter, randomized, unblinded, clinical trial study. Patients were randomized into three groups: group A: SWL (194 pts); group B: RIRS (207 pts); group C: PCNL (181 pts). Patients were evaluated with KUB radiography (US for uric acid stones) at day 10 and a CT scan after 3 months. The CONSORT 2010 statement was adhered to where possible. The collected data were analyzed.

Results

The mean stone size was 13.78 mm in group A, 14.82 mm in group B and 15.23 mm in group C (p = 0.34). Group C compared to group B showed longer operative time [72.3 vs. 55.8 min (p = 0.082)], fluoroscopic time [175.6 vs. 31.8 min (p = 0.004)] and hospital stay [3.7 vs. 1.3 days (p = 0.039)]. The overall stone-free rate (SFR) was 61.8% for group A, 82.1% for group B and 87.3% for group C. The re-treatment rate was significantly higher in group A compared to the other two groups, 61.3% (p < 0.05). The auxiliary procedure rate was comparable for groups A and B and lower for group C (p < 0.05). The complication rate was 6.7, 14.5 and 19.3% for groups A, B and C, respectively.

Conclusions

RIRS and PCNL were more effective than SWL to obtain a better SFR and less auxiliary and re-treatment rate in single lower calyceal stone with a CT diameter between 1 and 2 cm. RIRS compared to PCNL offers the best outcome in terms of procedure length, radiation exposure and hospital stay.

ISRCTN 55546280.

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Title: A prospective randomized comparison among SWL, PCNL and RIRS for lower calyceal stones less than 2 cm: a multicenter experience
A better understanding on the treatment options for lower pole stones
Authors: G. Bozzini
P. Verze
D. Arcaniolo
O. Dal Piaz
N. M. Buffi
G. Guazzoni
M. Provenzano
B. Osmolorskij
F. Sanguedolce
E. Montanari
N. Macchione
K. Pummer
V. Mirone
M. De Sio
G. Taverna
Publication date: 01-12-2017
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 12/2017
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-017-2084-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A prospective randomized comparison among SWL, PCNL and RIRS for lower calyceal stones less than 2 cm: a multicenter experience

A better understanding on the treatment options for lower pole stones

Abstract

Purpose

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusions

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