Comparison of Ureteroscopic Holmium Laser lithotripsy and ESWL in Treatment of Ureteric Stones

Abstract

The urologists have several options for treating ureteral stones in the range of 8-15mm. Of that range, this study makes a comparison between ESWL and ureteroscopic holmium laser lithotripsy in the treatment of ureteric stone. In spite of that ureteroscopy and ESWL are invasive procedures, still there is controversy which of them is more suitable for treating ureteral stones condition. Study Aim: This study conducts a review to compare the effectiveness, safety and complications of using ureteroscopic holmium laser lithotripsy and ESWL in treating of ureteral stones. Study Methods: Eighty ureteroscopic holmium laser lithotripsy or ESWL-treated patients between April 2016 and April 2017 in Al-Diwaneyah teaching hospital who is having 8–14mm single radiopaque ureteral stone, were assessed. All of the patients in the study sample were subjected to follow-up period of seven months using ultrasonography. Then, comparison was made to identify stone clearance rate, potential complications and cost. Study Results: Results show that There is resemblance in treatment time and stone clearance rate between the two treatments. Generally, the total cost, the procedural time and analgesia requirements and were noticeably variant. Additionally, gross hematuria and renal colic were more frequent with ESWL procedure, while the voiding symptoms show more frequency with ureteroscopy procedure. The two procedures that were applied for the treatment of 8-14mm range ureteral stones proved to be the least invasive and secure.

Flexible Ureteroscopic Laser Lithotripsy versus Extracorporeal Shock Wave Lithotripsy in Management of Upper Ureteral Calculi up to 2 cm

“…This copes with Kartal I et al [16] and Aboutaleb H et al [18] Cui Y et al [19] showed no significantly difference in between FURS and laser lithotripsy an ESWL (mean 40.0± 10.0, 42.5± 11.3, for FURS and ESWL respectively, P-value 0.29). Also, Obaid A et al [17] showed no significant difference. This may be due to their experience, availability of equipment and ureteric diameter which allows easy introduction of ureteroscope.…”

“…Cui Y et al [19] showed no significantly difference in between FURS and laser lithotripsy an ESWL (97.5%, 87.5% and 92.5% P-value 0.2 and 0.6) for FURS, ESWL second session and ESWL third session respectively. Also, Obaid A et al [17] showed no significant difference. Also, Elkholy M et al [21] on 50 patients had proximal ureteral stones and 47 patients had middle ureteral stones, showed a higher success rate than the current study, where the overall success rate was 94%.…”

“…Also, comparison between radiologic finding of stones in both group including size and site, showed no significant difference. These cope with most of researchers like Kartal I et al [16], Obaid A et al [17], Aboutaleb H et al [18], Cui Y et al [19] and Kartal I et al [16] and guarantee the matching in our sample selection.…”

Comparația Metodelor De Tratament Al Litiazei Renoureterale Prin Ureteroscopie Laser Holmium Și Litotriție Extracorporeală Cu Unde De Șoc (Eswl)

“…Tehnica ESWL a început să fie utilizată în anii 1980 și a dat o rată de eliminare a calcului până la 90% după trei ședințe de ESWL. În plus, această tehnică duce la scăderea utilizării chirurgiei deschise pentru gestionare litiazei renoureterale [9][10][11]. Progresele ulterioare în tratamentul ESWL l-au făcut capabil să schimbe tactica de aplicare în tratamentul de prima linie.…”