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Published in: Urolithiasis 1/2023

01-12-2023 | Ureterorenoscopy | Research

Prospective comparison of extracorporeal shock wave lithotripsy and ureteroscopy in distal ureteral stones

Authors: Zheng Gong, Yipeng Li, Huijing Zhang, Chunyu Pan, Jia Li, Gang Liu, Song Bai

Published in: Urolithiasis | Issue 1/2023

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Abstract

The optimal treatment modality of distal ureteral stones is controversial. Therefore, we conducted a prospective study to evaluate the efficacy, safety, and cost of early second shock wave lithotripsy (SWL) sessions versus ureterorenoscopy (URS) in patients with distal ureteral stones. This prospective study was conducted in a tertiary hospital from June 2020 to April 2022. Patients who underwent SWL or URS for distal ureteral stones were enrolled in this study. The stone-free rate (SFR), secondary treatment rate, complications, and costs were recorded. Propensity-score matching (PSM) analysis was also performed. A total of 1023 patients were included, of whom 68.4% (700) were treated with SWL and 31.6% (323) with URS. Based on PSM, SWL had an equivalent SFR (87.4% vs. 84.9%, P = 0.325) at one month after SWL and secondary treatment rate (10.7% vs.10.8%, P = 0.958) when compared with URS. Complications were rare and comparable between the SWL and URS groups (6.0% vs. 5.9%, P > 0.05), while the incidence of ureteral injuries (i.e., perforations) was higher in the URS group compared with the SWL group (1.3% vs. 0%, P = 0.019). The hospital stay was significantly shorter (1 day vs. 2 days, P < 0.001) and the costs considerably less (2000 RMB vs. 25,030 RMB; P < 0.001) in the SWL group compared with the URS group. This prospective study demonstrated that early second SWL sessions had equivalent efficacy in addition to reduced complication rates and costs compared with URS in patients with distal ureteral stones. Our findings may help guide clinical decision making.
Literature
1.
go back to reference Sorokin I, Mamoulakis C, Miyazawa K, Rodgers A, Talati J, Lotan Y (2017) Epidemiology of stone disease across the world. World J Urol 35(9):1301–1320CrossRefPubMed Sorokin I, Mamoulakis C, Miyazawa K, Rodgers A, Talati J, Lotan Y (2017) Epidemiology of stone disease across the world. World J Urol 35(9):1301–1320CrossRefPubMed
2.
go back to reference Graber SF, Danuser H, Hochreiter WW, Studer UE (2003) A prospective randomized trial comparing 2 lithotriptors for stone disintegration and induced renal trauma. J Urol 169(1):54–57CrossRefPubMed Graber SF, Danuser H, Hochreiter WW, Studer UE (2003) A prospective randomized trial comparing 2 lithotriptors for stone disintegration and induced renal trauma. J Urol 169(1):54–57CrossRefPubMed
3.
go back to reference Drake T, Grivas N, Dabestani S, Knoll T, Lam T, Maclennan S, Petrik A, Skolarikos A, Straub M, Tuerk C, Yuan CY, Sarica K (2017) What are the benefits and harms of ureteroscopy compared with shock-wave lithotripsy in the treatment of upper ureteral stones? Syst Rev Eur Urol 72(5):772–786CrossRef Drake T, Grivas N, Dabestani S, Knoll T, Lam T, Maclennan S, Petrik A, Skolarikos A, Straub M, Tuerk C, Yuan CY, Sarica K (2017) What are the benefits and harms of ureteroscopy compared with shock-wave lithotripsy in the treatment of upper ureteral stones? Syst Rev Eur Urol 72(5):772–786CrossRef
5.
go back to reference 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 I J Urol 196(4):1153–1160CrossRefPubMed 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 I J Urol 196(4):1153–1160CrossRefPubMed
6.
go back to reference Dasgupta R, Cameron S, Aucott L, MacLennan G, Thomas RE, Kilonzo MM, Lam TBL, N’Dow J, Norrie J, Anson K, Burgess N, Clark CT, Keeley FX Jr, MacLennan SJ, Starr K, McClinton S (2021) Shockwave lithotripsy versus ureteroscopic treatment as therapeutic interventions for stones of the ureter (TISU): a multicentre randomised controlled non-inferiority trial. Eur Urol 80(1):46–54. https://doi.org/10.1016/j.eururo.2021.02.044CrossRefPubMedPubMedCentral Dasgupta R, Cameron S, Aucott L, MacLennan G, Thomas RE, Kilonzo MM, Lam TBL, N’Dow J, Norrie J, Anson K, Burgess N, Clark CT, Keeley FX Jr, MacLennan SJ, Starr K, McClinton S (2021) Shockwave lithotripsy versus ureteroscopic treatment as therapeutic interventions for stones of the ureter (TISU): a multicentre randomised controlled non-inferiority trial. Eur Urol 80(1):46–54. https://​doi.​org/​10.​1016/​j.​eururo.​2021.​02.​044CrossRefPubMedPubMedCentral
7.
go back to reference Etafy M, Morsi GA, Beshir MS, Soliman SS, Galal HA, Ortiz-Vanderdys C (2014) Management of lower ureteric stones: a prospective study. Cent Eur J Urol 66(4):456–462 Etafy M, Morsi GA, Beshir MS, Soliman SS, Galal HA, Ortiz-Vanderdys C (2014) Management of lower ureteric stones: a prospective study. Cent Eur J Urol 66(4):456–462
8.
go back to reference Lawler AC, Ghiraldi EM, Tong C, Friedlander JI (2017) Extracorporeal shock wave therapy: current perspectives and future directions. Curr Urol Rep 18(4):25CrossRefPubMed Lawler AC, Ghiraldi EM, Tong C, Friedlander JI (2017) Extracorporeal shock wave therapy: current perspectives and future directions. Curr Urol Rep 18(4):25CrossRefPubMed
9.
go back to reference Ghalayini IF, Al-Ghazo MA, Khader YS (2006) Extracorporeal shockwave lithotripsy versus ureteroscopy for distal ureteric calculi: efficacy and patient satisfaction. Int Braz J Urol 32(6):656–667CrossRefPubMed Ghalayini IF, Al-Ghazo MA, Khader YS (2006) Extracorporeal shockwave lithotripsy versus ureteroscopy for distal ureteric calculi: efficacy and patient satisfaction. Int Braz J Urol 32(6):656–667CrossRefPubMed
10.
go back to reference Abdelbary AM, Al-Dessoukey AA, Moussa AS, Elmarakbi AA, Ragheb AM, Sayed O, Elbatanouny AM, Latif AAE, Lofty AM, Mohamed AG, Salah S, Ibrahim RM (2021) Value of early second session shock wave lithotripsy in treatment of upper ureteric stones compared to laser ureteroscopy. World J Urol 39(8):3089–3093CrossRefPubMed Abdelbary AM, Al-Dessoukey AA, Moussa AS, Elmarakbi AA, Ragheb AM, Sayed O, Elbatanouny AM, Latif AAE, Lofty AM, Mohamed AG, Salah S, Ibrahim RM (2021) Value of early second session shock wave lithotripsy in treatment of upper ureteric stones compared to laser ureteroscopy. World J Urol 39(8):3089–3093CrossRefPubMed
11.
go back to reference Agha R, Abdall-Razak A, Crossley E, Dowlut N, Iosifidis C, Mathew G, STROCSS Group (2019) STROCSS 2019 guideline: strengthening the reporting of cohort studies in surgery. Int J Surg (London, England) 72:156–165CrossRef Agha R, Abdall-Razak A, Crossley E, Dowlut N, Iosifidis C, Mathew G, STROCSS Group (2019) STROCSS 2019 guideline: strengthening the reporting of cohort studies in surgery. Int J Surg (London, England) 72:156–165CrossRef
12.
go back to reference Verze P, Imbimbo C, Cancelmo G, Creta M, Palmieri A, Mangiapia F, Buonopane R, Mirone V (2010) Extracorporeal shockwave lithotripsy vs ureteroscopy as first-line therapy for patients with single, distal ureteric stones: a prospective randomized study. BJU Int 106(11):1748–1752CrossRefPubMed Verze P, Imbimbo C, Cancelmo G, Creta M, Palmieri A, Mangiapia F, Buonopane R, Mirone V (2010) Extracorporeal shockwave lithotripsy vs ureteroscopy as first-line therapy for patients with single, distal ureteric stones: a prospective randomized study. BJU Int 106(11):1748–1752CrossRefPubMed
13.
go back to reference Pearle MS, Nadler R, Bercowsky E, Chen C, Dunn M, Figenshau RS, Hoenig DM, McDougall EM, Mutz J, Nakada SY, Shalhav AL, Sundaram C, Wolf JS Jr, Clayman RV (2001) Prospective randomized trial comparing shock wave lithotripsy and ureteroscopy for management of distal ureteral calculi. J Urol 166(4):1255–1260CrossRefPubMed Pearle MS, Nadler R, Bercowsky E, Chen C, Dunn M, Figenshau RS, Hoenig DM, McDougall EM, Mutz J, Nakada SY, Shalhav AL, Sundaram C, Wolf JS Jr, Clayman RV (2001) Prospective randomized trial comparing shock wave lithotripsy and ureteroscopy for management of distal ureteral calculi. J Urol 166(4):1255–1260CrossRefPubMed
14.
go back to reference Peschel R, Janetschek G, Bartsch G (1999) Extracorporeal shock wave lithotripsy versus ureteroscopy for distal ureteral calculi: a prospective randomized study. J Urol 162(6):1909–1912CrossRefPubMed Peschel R, Janetschek G, Bartsch G (1999) Extracorporeal shock wave lithotripsy versus ureteroscopy for distal ureteral calculi: a prospective randomized study. J Urol 162(6):1909–1912CrossRefPubMed
15.
go back to reference Honeck P, Häcker A, Alken P, Michel MS, Knoll T (2006) Shock wave lithotripsy versus ureteroscopy for distal ureteral calculi: a prospective study. Urol Res 34(3):190–192CrossRefPubMed Honeck P, Häcker A, Alken P, Michel MS, Knoll T (2006) Shock wave lithotripsy versus ureteroscopy for distal ureteral calculi: a prospective study. Urol Res 34(3):190–192CrossRefPubMed
16.
go back to reference 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 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
17.
go back to reference 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 27(9):749–754CrossRefPubMed 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 27(9):749–754CrossRefPubMed
Metadata
Title
Prospective comparison of extracorporeal shock wave lithotripsy and ureteroscopy in distal ureteral stones
Authors
Zheng Gong
Yipeng Li
Huijing Zhang
Chunyu Pan
Jia Li
Gang Liu
Song Bai
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/s00240-023-01460-4

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