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Pricop C. et al., 2021: Determining whether previous SWL for ureteric stones influences the results of ureteroscopy as the second-line treatment: A clinical study.

Pricop C, Ivanuta M, Radavoi GD, Toma CV, Cumpanaş A, Jinga V, Bacalbaşa N, Puia D.
Department of Urology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iași, Romania.
Department of Urology, 'C. I. Parhon' Hospital, 700503 Iași, Romania.
Department of Urology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Department of Urology, 'Prof. Dr. Theodor Burghele' Clinical Hospital, 050653 Bucharest, Romania.
Department of Urology, 'Victor Babeş' University of Medicine and Pharmacy, 300041 Timișoara, Romania.
Department of Urology, 'Pius Brînzeu' County Emergency Clinical Hospital Timiş, 300723 Timișoara, Romania.
Department of Visceral Surgery, Center of Excellence in Translational Medicine, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania.

Abstract

The purpose of the study was to establish whether shock wave lithotripsy (SWL) is a potential harmful first-line treatment for ureteric stones where ureteroscopy (URS) is necessary as a second-line treatment. Medical records of patients with ureteric stones who underwent either URS as the only therapy applied or SWL followed by URS over two years were retrospectively evaluated. In total, 158 patients were included: 79 patients in Group A (no SWL) and 79 in Group B (prior SWL before URS). There was no difference in major complications, Group A had higher stone-free rates, Group B had higher rates of ureteral edema and similar intraoperative ureteral lesions. In conclusion, the failure of SWL for lumbar or pelvic ureteral lithiasis does not appear to have a negative effect on the rate of intraoperative complications or the success rate of semi-rigid retrograde URS for this category of calculi, with the same safety profile as first-line endourological intervention.
Exp Ther Med. 2022 Jan;23(1):38. doi: 10.3892/etm.2021.10960. Epub 2021 Nov 11. PMID: 34849153. FREE ARTICLE

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Comments 1

Peter Alken on Tuesday, 19 April 2022 10:15

“If after more than two SWL sessions the X-ray did not show the disintegration of the stone two weeks from the last procedure, it was considered as treatment failure and the patient underwent URS.” The only highly significant difference of the two groups was mucosal edema seen during primary URS (group A) in 30.37% (n=24) and during secondary URS (group B) in 67.08% (n=53) p less than 0,00001. OR time was slightly longer in group B [74.9 min (±13)] vs. group A [65.8 min (±14)] less than 0, 05. It is unclear if these differences were consequences of ESWL or just secondary to the stone and selection bias.

Peter Alken

“If after more than two SWL sessions the X-ray did not show the disintegration of the stone two weeks from the last procedure, it was considered as treatment failure and the patient underwent URS.” The only highly significant difference of the two groups was mucosal edema seen during primary URS (group A) in 30.37% (n=24) and during secondary URS (group B) in 67.08% (n=53) p less than 0,00001. OR time was slightly longer in group B [74.9 min (±13)] vs. group A [65.8 min (±14)] less than 0, 05. It is unclear if these differences were consequences of ESWL or just secondary to the stone and selection bias. Peter Alken
Sunday, 16 June 2024