Yan K. et al., 2024: Comparison of the Effects of Ureteroscopy with Holmium Laser Lithotripsy and Extracorporeal Shock Wave Lithotripsy in the Treatment of Ureteral Calculi.
Yan K, Wu H, Luo E.
Abstract
Objective: This study aims to compare the efficacy of ureteroscopy with holmium laser lithotripsy and extracorporeal shock wave lithotripsy (ESWL) in treating ureteral calculus (UC).
Methods: We enrolled 86 patients with UC treated in our urology department from November 2020 to November 2022. Group A (n=43) underwent ureteroscopic holmium laser lithotripsy, while Group B (n=43) received ESWL. We recorded treatment duration, post-treatment hematuria duration, and post-treatment stone clearance rates. Renal function and stress response were assessed before and 3 days after treatment. Post-treatment complications were documented, and patient quality of life was evaluated using the SF-36 health questionnaire.
Results: Group A exhibited significantly shorter treatment and post-treatment hematuria durations compared to Group B (P < .05). In stones >1 cm, group A demonstrated a higher clearance rate (P < .05). Post-treatment, Group A showed improved renal function and lower stress response (P < .05). The incidence of post-treatment complications did not differ significantly between groups (P > .05), but SF-36 scores were higher in Group A (P < .05).
Conclusions: Ureteroscopy with holmium laser lithotripsy proves effective in UC treatment, contributing to a shortened recovery period and enhanced patient quality of life.
Altern Ther Health Med. 2024 Jan 31:AT9366. Online ahead of print. PMID: 38330585 FREE ARTICLE
Comments 1
The authors of this report compared URS (URL; Group A)) and SWL (Group B) of ureteral stones. The study is retrospective and there is no information on how patients were referred to each one of these groups or how patients were selected for the analysis.
Moreover, the authors mention URS as a non-invasive procedure, but low-invasive would be a more appropriate description. This is particularly obvious when ureteral strictures and injuries are discussed further down in in introduction.
There are some confusions in the text since Group B underwent “ureteroscopic ESWL” and that the number of shockwaves was “28 000”. But most confusing is it that whereas two patients in Group A had ureteral stenosis (which seems reasonable) these two cases are referred to Group B (ESWL) in Table 3.
What the authors mean by “combination of URL with ESWL” is not clear and nothing that is described in detail.
The results are in line with previously reported literature data, but it had been an advantage with a better proof-read and more stringent report.
Hans-Göran Tiselius