18. Treatment of Large Proximal Ureteral Stones: Extracoporeal Shock Wave Lithotripsy versus Ureterolithotrisy versus Laparoscopic Ureterolithotomy
Asif Imran,1 Abid Hussain2 and Muhammad Ismail Seerat2
Objective: To compare efficacy of extracorporeal shock wave lithotripsy, rigid ureterolithotripsy, and laparoscopic ureterolithotomy in treatment of large proximal ureteral stones. Study Design: Prospective randomized study.
Place and Duration of Study: This study was conducted at the Department of Urology, Lahore General Hospital, Lahore from March 2012 to March 2014.
Materials and Methods: A total of 40 patients with large proximal ureteral stones (greater than 1cm) were prospectively randomized for study at Postgraduate Medical Institute Lahore. Eligible patients were treated with extracorporeal shock wave lithotripsy, rigid ureterolithotripsy and laparoscopic ureterolithotomy.
Results: Extracorporeal shock wave lithotripsy had 37.5% success rate, rigid ureterolithotripsy 64.3% and laparoscopic ureterolithotomy 90%. Fewer treatment sessions were required with laparoscopic ureterolithotomy vs rigid ureterolithotripsy vs extracorporeal shock wave lithotripsy (mean±SD1.6±0.5vs2.1±o.9±vs2.7±1.07,p=0.017)
Conclusion: Higher success rate is achieved with laparoscopic ureterolithotomy in treatment of large proximal ureteral stones but with fewer additional procedures. It is associated with more postoperative pain,longer procedure and a longer hospital stay. It is more advantageous than open ureterolithotomy, remains a salvage, second line procedure in treatment of large proximal ureteral stones.
Key Words: Proximal Ureteral Stones, Extracoporeal Shock Wave Lithotripsy, Ureterolithotrisy, Laparoscopic Ureterolithotomy
Citation of articles: Imran A, Hussain A. Seerat MI. Treatment of Large Proximal Ureteral Stones: Extracoporeal Shock Wave Lithotripsy versus Ureterolithotrisy versus Laparoscopic Ureterolithotomy. Med Forum 2017;28(12):72-75.