Soliman T et al, 2016: Miniperc versus shockwave lithotripsy for average sized radiopaque lower pole calculi: A prospective randomized study.
Soliman T, Sherif H, Ahmed AS, Mohey A, Almohamdy B.
1Urology Department, Faculty of Medicine, Benha University, Benha, Egypt.
INTRODUCTION: To detect safety and feasibility of miniperc and SWL for treatment of average sized (1-2 cm) radiopaque lower pole calculi in a prospective randomized manner.
MATERIAL AND METHODS: In the period from January 2014 to June 2015, 150 patients were attached to this study with single lower pole radiopaque stone ranging from 10- 20mm. Patients were divided randomly into two groups using computer generated randomization in an equal manner. First group patients were subjected to miniperc procedure while second group patients underwent SWL. Patient's characters, stones' characters, fluoroscopic time, operative time, blood transfusion, hospital stay, retreatment, auxiliary procedure and complications using modified Clavien grading are tabulated and analyzed.
RESULTS: This study included 2 equal groups 75 patients in each group. As regard age (37.75±11.25 vs 40.55±10.55), BMI (26.92±2.26 vs 27.29±2.87) and stone size (1.55±0.28 vs 1.57±0.26) there was no significant statistically difference in both groups. SFR (76% vs 96%), Operative time (44.81±7.06 vs 93.37±12.29 min), fluoroscopy time (53± 2.45 vs 180±7.31sec.), hospital stay (5.72 ±1.01 vs 45.19 ± 8.48 hour) and blood transfusion were significantly more in miniperc group. Retreatment rate (45.3% vs 2.7%) and auxiliary procedure (24% vs 4%) were significantly greater in SWL group.
CONCLUSION: Shock wave lithotripsy is less invasive than percutaneous stone removal but it is also less effective for lower pole radiopaque calculi. Miniperc has better SFR, lower auxiliary and retreatment rates, however it resulted in more drawbacks.
J Endourol. 2016 Sep 27. [Epub ahead of print]
The results were to be expected and are in fact even more unfavourable for ESWL. The present paper gives - as many other publications on that subject - a misleading view on the operative and fluoroscopy times and the hospital stay. The mean values do not take into account that multiple sessions were needed in the SWL group. 34 patients (45.3%) needed a 2nd session and 23 patients (30.6%) needed a 3rd session.