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.
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]. FREE ARTICLE
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.