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Gürbuz ZG et al, 2018: Small renal pelvis stones: Shock wave lithotripsy or flexible ureteroscopy? A match-pair analysis.

Gürbuz ZG, Şener NC, Vuruşkan E, Deniz ME, Gürlen G, Ortoğlu F.
Department of Urology, University of Health Sciences, Adana City Teaching and Research Hospital, Adana, Turkey.

Abstract

OBJECTIVE: Kidney stones in renal pelvis may be treated using various methods. For larger stones, percutaneous nephrolitotomy (PNL) is the first choice of option; where for smaller stones, shock wave lithotripsy (SWL) or flexible ureteroscopy (F-URS) could be more suitable options. In this article we aimed to compare the outcomes of F-URS and SWL on the treatment of renal pelvis stones <10 mm. MATERIAL AND METHODS: Files of patients treated with SWL and F-URS for renal pelvis stones <10 mm between March 2013 and May 2016 in our clinic were analyzed. For comparison, a match-pair analysis was designed. Complete stone removal was considered success.
RESULTS: Forty patients were treated using F-URS (Group 1) and 40 patients underwent SWL (Group 2). Patients were assessed the day after the last session of the procedure. The early stone-free rates were 70% (28/40) in Group 1, and 15% in Group 2 (p<0.05). The same analysis was performed after three months. Stone-free rates were 100% and 92.5% in Groups 1 and 2, respectively (p=0.079). Three patients in Group 2 were not stone free after 3 sessions of SWL and considered unsuccessful. They were all successfully treated by F-URS.
CONCLUSION: Even though there is no statistical difference among groups, our data may be interpreted as having better outcomes and tolerability with F-URS than SWL. We believe F-URS may have a great treatment prospect in this particular patient group.

Turk J Urol. 2018 Sep 4:1-4. doi: 10.5152/tud.2018.70094. [Epub ahead of print]

 

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Comments 1

Peter Alken on Friday, 09 November 2018 11:55

In the fURS group an 11.5/9.5 F ureteral access sheath was placed in all cases obviously without problems. No patient had a primary access failure and no patient needed a postprocedural DJ and all patients were treated with one session. This a little bit unusual even for a matched pair analysis. ESWL patients needed 1.85±0.11 sessions.

In the fURS group an 11.5/9.5 F ureteral access sheath was placed in all cases obviously without problems. No patient had a primary access failure and no patient needed a postprocedural DJ and all patients were treated with one session. This a little bit unusual even for a matched pair analysis. ESWL patients needed 1.85±0.11 sessions.
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