To Compare the Effectiveness of Transurethral Pneumatic Lithotripsy and Extracorporeal Shock Wave Lithotripsy: In treatment of Lower Ureteric Stones

Abstract

Background: One of the most common complaint in the ER is colic due to Ureteric calculi. They usually pass out but stones > 5mmmay require intervention. ESWL and TPL are one of the treatment options.Objectives: To compare the effectiveness of transurethral pneumatic lithotripsy (TPL) and extracorporeal shock wavelithotripsy(ESWL) in treatment of lower ureteric stones.Material and Methods: Over period of six months a group of 70 patients presenting with ureteric calculi were randomly allocated intwo groups. Group Aunderwent TPL while Group B ESWL. Follow up was done to determine the effectiveness with regards to stoneclearance.Results: The mean age of the whole study sample was 35.6 + 8.5 years. The difference between mean age of both groups wasstatistically not significant (p 0.665). there were 70% males compared to 30% females in the overall sample and the difference ofgender across both groups was comparable (p 0.192). The mean size of stone of the whole study sample at presentation was 6.4 +2.5mm and the duration of illness was 4.8 + 1.8months. On follow up, the effectiveness of the procedure in terms of stone clearancewas recorded in 88.6% of TPL group and 77.1% of ESWL group (p 0.205).Conclusion: TPL is comparable to the ESWL in terms of its effectiveness for ureteric calculi of size less than or equal to 10mm.More research trials need to be done for conclusive outcome.Key Words: Urolithiasis, ureteric calculi, transurethral pneumatic lithotripsy, extracorporeal shock wave lithotripsy, stoneclearance

A systematic review and meta-analysis on the outcomes of extracorporeal shock wave compared to ureteroscopic lithotripsy for the treatment of ureteral stones

“…There were 677 ESWL patients and 832 URSL patients and the two procedures were analyzed to determine the effect of these two procedures on treatment outcomes. Of the final ten studies, five took place in Pakistan, 1 , 2 , 5 , 17 , 18 , 19 two in Nepal, 4 , 20 one in Japan, 21 and two in Egypt. 22 , 23 All of the studies reported the outcomes of both ESWL and URS lithotripsy procedures.…”

“…When medical treatments fail, the two most commonly reported replacement treatments are Extracorporeal Shock Wave Lithotripsy (ESWL) and Ureteroscopic Lithotripsy (URSL) which are performed with rigid-flexible and semi-flexible lithotripters. 1 , 2 …”