Comparison between Intracorporeal Pneumatic Lithotripsy and Extracorporeal Shock Wave Lithotripsy (ESWL) in terms of efficacy and Safety for Management of Proximal Ureteric Stones

M. Amjad, I. Hyder, R. A. Rehman, H. Shafi, M. Seerwan, Ali Shandar Durrani
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Abstract

Objective: To compare efficacy and safety of intracorporeal pneumatic lithotripsy versus extracorporeal shock wave lithotripsy (ESWL) in patients of upper ureteric stones having stone size from 10 to 15 mm. Study Design: Randomized control trial Setting: Study was done at department of Urology, Nishtar Hospital Multan. The duration of the study was from January 2021 to January 2022. Methodology: 140 patients were divided into two groups randomly. In group A ureterorenoscopy (URS) with Pneumatic Lithotripsy was used for proximal ureteric stones management. URS was performed under general anesthesia. In group B, ESWL was done for the management of proximal ureteric stones identified by ultrasound and fluoroscopy. SPSS version 23 was used for data analysis. Results: In this study In Intracorporeal Pneumatic Lithotripsy group the stone cleared in 90% patients and in ESWL group the stone cleared in 78.6% patients (p-value=0.595). In Intracorporeal Pneumatic Lithotripsy group the pain was present in 14.3% patients and in ESWL group the pain was present in 18.6% patients (p-value=0.494). In Intracorporeal Pneumatic Lithotripsy group the bleeding was noted in 25.7% patients and in ESWL group the bleeding was noted in 40.0% patients (p-value=0.072). Conclusion: This study concluded that intracorporeal pneumatic lithotripsy is a good alternate of ESWL for the management of upper ureteric stones (having size from 10 to 15mm). Keywords: Urolithiasis, Intracorporeal Pneumatic Lithotripsy, Extracorporeal Shock Wave Lithotripsy, Ureteric Stone
体外冲击波碎石术(ESWL)与体外气压碎石术(ESWL)治疗输尿管近端结石疗效及安全性比较
目的:比较体外冲击波碎石术(ESWL)与体外气压碎石术(ESWL)治疗10 ~ 15mm输尿管上段结石的疗效和安全性。研究设计:随机对照试验设置:研究在木尔坦Nishtar医院泌尿科完成。研究时间为2021年1月至2022年1月。方法:140例患者随机分为两组。A组采用输尿管镜联合气压碎石术治疗输尿管近端结石。全麻下进行尿潴留。B组对经超声和透视检查发现的输尿管近端结石行体外冲击波碎石治疗。使用SPSS version 23进行数据分析。结果:体外气压碎石组结石清除率为90%,体外碎石组结石清除率为78.6% (p值=0.595)。体外气压碎石组疼痛发生率为14.3%,体外碎石组为18.6% (p值=0.494)。体外气压碎石组出血发生率为25.7%,体外冲击波碎石组出血发生率为40.0% (p值=0.072)。结论:体外气压碎石术是治疗输尿管上段结石(直径10 ~ 15mm)的较好方法。关键词:尿石症,体外气压碎石,体外冲击波碎石,输尿管结石
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