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Ali M et al, 2018: Shock wave lithotripsy versus endoscopic cystolitholapaxy in the management of patients presenting with calcular acute urinary retention: a randomised controlled trial.

Ali M, Hashem A, Helmy TE, Zewin T, Sheir KZ, Shokeir AA.
Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.

Abstract

PURPOSE: Shock wave lithotripsy (SWL) in treatment of bladder and urethral stones was not precisely determined. The objective of this study is to compare the efficacy and safety of SWL versus visual cystolitholapaxy in the management of calcular acute urine retention.
METHODS: From March 2015 to February 2017, a randomised controlled study was conducted on 100 patients for whom urethral catheter fixed for acute retention of urine due to urethral or vesical radio-opaque stone(s) ≤ 2 cm. Patients were randomised to either SWL group (n = 50) or visual cystolitholapaxy (endoscopy group) (n = 50).
RESULTS: No statistically significant differences between the pre-operative parameters of both groups were found. The mean stone diameter was 12.2 ± 3 mm and 12.2 ± 3.2 mm in SWL and endoscopy groups, respectively (p value = 0.4). The overall success rates of SWL group were 94% (47 of 50 patients) and endoscopy group were 98% (49 of 50 patients). SWL failed in 3 patients (6%); these 3 patients underwent cystolitholapaxy and were rendered free of stones. Intra-operative and post-operative complications were comparable between both groups (p value = 0.5 and 1, respectively). One patient had bladder perforation in the endoscopy group and was managed conservatively.
CONCLUSIONS: SWL mono-therapy is safe, non-invasive and as effective as visual cystolitholapaxy in management of patients presenting with acute urine retention by vesical or urethral stones 2 cm or less and could be useful for patients unwilling/unfit for general anaesthesia.

World J Urol. 2018 Aug 13. doi: 10.1007/s00345-018-2434-0. [Epub ahead of print]

 

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Commentaires 1

Peter Alken le jeudi 6 décembre 2018 14:48

Very good results with ESWL on bladder stones integrate and clear stones in 43 patients (86%), while 2 patients required 2 sessions (4%) and another 2 patients required 3 sessions (4%)”
“SWL failed in treatment of three patients (6%): two patients (4%) were failure of clearance even after achieving adequate fragmentation and one patient (2%) had no
fragmentation at all.“

Very good results with ESWL on bladder stones integrate and clear stones in 43 patients (86%), while 2 patients required 2 sessions (4%) and another 2 patients required 3 sessions (4%)” “SWL failed in treatment of three patients (6%): two patients (4%) were failure of clearance even after achieving adequate fragmentation and one patient (2%) had no fragmentation at all.“
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