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Urolithiasis
Published in: Urolithiasis 1/2023

01-12-2023 | Ureterorenoscopy | Research

Prospective comparison of extracorporeal shock wave lithotripsy versus flexible ureterorenoscopy in patients with non–lower pole kidney stones under the COVID-19 pandemic

Authors: Song Bai, Yunhong Zhan, Chunyu Pan, Gang Liu, Jia Li, Liping Shan

Published in: Urolithiasis | Issue 1/2023

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Abstract

Both shock wave lithotripsy (SWL) and flexible ureterorenoscopy (F-URS) are recommended as the first choice for non-lower pole kidney stones. Therefore, we conducted a prospective study to evaluate the efficacy, safety, and cost of SWL versus F-URS in patients with solitary non-lower pole kidney stones ≤ 20 mm under the COVID-19 pandemic. This prospective study was conducted in a tertiary hospital from June 2020 to April 2022. Patients who underwent lithotripsy (SWL or F-URS) for non-lower pole kidney stones were enrolled in this study. The stone-free rate (SFR), retreatment rate, complications, and cost were recorded. Propensity score-matched (PSM) analysis was performed. A total of 699 patients were finally included, of which 81.3% (568) were treated with SWL and 18.7% (131) underwent F-URS. After PSM, SWL showed equivalent SFR (87.9% vs. 91.1%, P = 0.323), retreatment rate (8.6% vs. 4.8%, P = 0.169), and adjunctive procedure (2.6% vs. 4.9%, P = 0.385) compared with F-URS. Complications were scarce and also comparable between SWL and F-URS (6.0% vs 7.7%, P > 0.05), while the incidence of ureteral perforation was higher in the F-URS group compared with the SWL group (1.5% vs 0%, P = 0.008). The hospital stay was significantly shorter (1 day vs 2 days, P < 0.001), and the cost was considerably less (1200 vs 30,083, P < 0.001) in the SWL group compared with the F-URS group. This prospective cohort demonstrated that SWL had equivalent efficacy with more safety and cost benefits than F-URS in treating patients with solitary non–lower pole kidney stones ≤ 20 mm. During the COVID-19 pandemic, SWL may have benefits in preserving hospital resources and limiting opportunity for virus transmission, compared to URS. These findings may guide clinical practice.
Literature
1.
Trinchieri A. et al. (2003) Epidemiology, In: Stone Disease, K.S. C.P. Segura JW, Pak CY, Preminger GM, Tolley D., (eds). Health Publications. Paris.
2.
Zhe M, Hang Z (2017) Nephrolithiasis as a risk factor of chronic kidney disease: a meta-analysis of cohort studies with 4,770,691 participants. Urolithiasis 45(5):441–448CrossRefPubMed
3.
Bas O, Bakirtas H, Sener NC, Ozturk U, Tuygun C, Goktug HN, Imamoglu MA (2014) Comparison of shock wave lithotripsy, flexible ureterorenoscopy and percutaneous nephrolithotripsy on moderate size renal pelvis stones. Urolithiasis 42(2):115–120CrossRefPubMed
4.
Assimos D, Krambeck A, Miller NL, Monga M, Murad MH, Nelson CP, Pace KT, Pais VM Jr, Pearle MS, Preminger GM, Razvi H, Shah O, Matlaga BR (2016) Surgical management of stones: American Urological Association/Endourological Society Guideline PART II. J Urol 196(4):1161–1169CrossRefPubMed
5.
6.
El-Nahas AR, Ibrahim HM, Youssef RF, Sheir KZ (2012) Flexible ureterorenoscopy versus extracorporeal shock wave lithotripsy for treatment of lower pole stones of 10–20 mm. BJU Int 110(6):898–902CrossRefPubMed
7.
Mi Y, Ren K, Pan H, Zhu L, Wu S, You X, Shao H, Dai F, Peng T, Qin F, Wang J, Huang Y (2016) Flexible ureterorenoscopy (F-URS) with holmium laser versus extracorporeal shock wave lithotripsy (ESWL) for treatment of renal stone <2 cm: a meta-analysis. Urolithiasis 44(4):353–365CrossRefPubMed
8.
Hiller SC, Dauw CA, Ghani KR, Collaborative MUSI (2020) Kidney stone care and the COVID-19 pandemic: challenges and opportunities. J Urol 204(6):1122–1124CrossRefPubMed
9.
Ozgor F, Sahan M, Yanaral F, Savun M, Sarilar O (2018) Flexible ureterorenoscopy is associated with less stone recurrence rates over shockwave lithotripsy in the management of 10–20 millimeter lower pole renal stone: medium follow-up results. Int Br J Off J Br Soc Urol 44(2):314–322CrossRef
10.
Kallidonis P, Ntasiotis P, Somani B, Adamou C, Emiliani E, Knoll T, Skolarikos A, Tailly T (2020) Systematic review and meta-analysis comparing percutaneous nephrolithotomy, retrograde intrarenal surgery and shock wave lithotripsy for lower pole renal stones less than 2 cm in maximum diameter. J Urol 204(3):427–433CrossRefPubMed
11.
Cecen K, Karadag MA, Demir A, Bagcioglu M, Kocaaslan R, Sofikerim M (2014) Flexible ureterorenoscopy versus extracorporeal shock wave lithotripsy for the treatment of upper/middle calyx kidney stones of 10–20 mm: a retrospective analysis of 174 patients. Springerplus 3(1):557CrossRefPubMedPubMedCentral
12.
Yoshida S, Takazawa R, Uchida Y, Kohno Y, Waseda Y, Tsujii T (2019) The significance of intraoperative renal pelvic urine and stone cultures for patients at a high risk of post-ureteroscopy systemic inflammatory response syndrome. Urolithiasis 47(6):533–540CrossRefPubMed
13.
Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213CrossRefPubMedPubMedCentral
14.
Fankhauser CD, Hermanns T, Lieger L, Diethelm O, Umbehr M, Luginbühl T, Sulser T, Müntener M, Poyet C (2018) Extracorporeal shock wave lithotripsy versus flexible ureterorenoscopy in the treatment of untreated renal calculi. Clin Kidney J 11(3):364–369CrossRefPubMedPubMedCentral
15.
Abe T, Akakura K, Kawaguchi M, Ueda T, Ichikawa T, Ito H, Nozumi K, Suzuki K (2005) Outcomes of shockwave lithotripsy for upper urinary-tract stones: a large-scale study at a single institution. J Endourol 19(7):768–773CrossRefPubMed
16.
Egilmez T, Tekin MI, Gonen M, Kilinc F, Goren R, Ozkardes H (2007) Efficacy and safety of a new-generation shockwave lithotripsy machine in the treatment of single renal or ureteral stones: experience with 2670 patients. J Endourol 21(1):23–27CrossRefPubMed
17.
Atis G, Gurbuz C, Arikan O, Canat L, Kilic M, Caskurlu T (2012) Ureteroscopic management with laser lithotripsy of renal pelvic stones. J Endourol 26(8):983–987CrossRefPubMed
18.
Geavlete P, Seyed Aghamiri SA, Multescu R (2006) Retrograde flexible ureteroscopic approach for pyelocaliceal calculi. Urol J 3(1):15–19PubMed
19.
Fankhauser CD, Weber D, Müntener M, Poyet C, Sulser T, Hermanns T (2021) Effectiveness of flexible ureterorenoscopy versus extracorporeal shock wave lithotripsy for renal calculi of 5–15 mm: results of a randomized controlled trial. Eur Urol Open Sci 25:5–10CrossRefPubMedPubMedCentral
20.
Ravier E, Abid N, Ruffion A, Fassi-Fehri H, Buron C, Ganne C, Mallet A, Martin X (2015) Effectiveness of flexible ureteroscopy versus extracorporeal shock wave lithotripsy for kidney stones treatment. Progres en Urol: J de l’Assoc Francaise D’Urol et de la Soc Francaise d’urol 25(5):233–239CrossRef
21.
Sheir KZ, Madbouly K, Elsobky E (2003) Prospective randomized comparative study of the effectiveness and safety of electrohydraulic and electromagnetic extracorporeal shock wave lithotriptors. J Urol 170(2 Pt 1):389–392CrossRefPubMed
22.
Resorlu B, Unsal A, Ziypak T, Diri A, Atis G, Guven S, Sancaktutar AA, Tepeler A, Bozkurt OF, Oztuna D (2013) Comparison of retrograde intrarenal surgery, shockwave lithotripsy, and percutaneous nephrolithotomy for treatment of medium-sized radiolucent renal stones. World J Urol 31(6):1581–1586CrossRefPubMed
23.
Kiremit MC, Guven S, Sarica K, Ozturk A, Buldu I, Kafkasli A, Balasar M, Istanbulluoglu O, Horuz R, Cetinel CA, Kandemir A, Albayrak S (2015) Contemporary management of medium-sized (10–20 mm) renal stones: a retrospective multicenter observational study. J Endourol 29(7):838–843CrossRefPubMed
24.
Farag M, Jack GS, Wong LM, Bolton DM, Lenaghan D (2020) What is the best way to manage ureteric calculi in the time of COVID-19? A comparison of extracorporeal shockwave lithotripsy (SWL) and ureteroscopy (URS) in an Australian health-care setting. BJUI compass 2(2):92–96CrossRefPubMedPubMedCentral
25.
Reicherz A, Maas V, Wenzel P, Dahlkamp L, Palisaar J, von Bodman C, Noldus J, Bach P (2020) Transient stent placement versus tubeless procedure after ureteroscopy retrograde surgery stone extraction (fast track stent study 2): a randomized prospective evaluation. Int J Urol Off J Jpn Urol Assoc 27(9):749–754
Metadata
Title
Prospective comparison of extracorporeal shock wave lithotripsy versus flexible ureterorenoscopy in patients with non–lower pole kidney stones under the COVID-19 pandemic
Authors
Song Bai
Yunhong Zhan
Chunyu Pan
Gang Liu
Jia Li
Liping Shan
Publication date
01-12-2023
Publisher
Springer Berlin Heidelberg
Published in
Urolithiasis / Issue 1/2023
Print ISSN: 2194-7228
Electronic ISSN: 2194-7236
DOI
https://doi.org/10.1007/s00240-023-01412-y

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