Outcomes of 10-20 mm Renal Stones: SWL vs. Flexible Ureteroscopy.

Abstract

Introduction: To compare the efficacy and safety of Shock Wave Lithotripsy (SWL) and flexible Ureteroscopy (fURS) in treating unilateral moderate-sized (10-20 mm) kidney stones, with a focus on changes in quality of life (QoL).

Methods: This study included 112 patients with unilateral radiopaque kidney stones. Patients were divided into two groups: SWL (n=64) and fURS (n=48). Treatment outcomes, including QoL changes, were evaluated comparatively between the groups.

Results: Both groups were similar in terms of age, gender, stone size, and density. Short-term (4-week) stone-free rates were higher in the fURS group (79.17% vs. 51.56%, p=0.003). However, at 3 months, there was no significant difference in stone-free rates (89.8% vs. 85.2%, p=0.098). Pain levels, assessed using the Visual Analog Scale (VAS), showed no difference 1 hour post-procedure (p=0.338), but SWL had lower pain scores at 4 hours (p=0.002). QoL, assessed with the SF-36 questionnaire, indicated an advantage for SWL in energy/fatigue parameters (p=0.017), with no significant differences in other domains. SWL was particularly beneficial for energy levels and emotional well-being.

Conclusions: SWL's non-invasive nature, reduced pain levels, and advantages in specific QoL parameters make it an effective treatment option for medium-sized kidney stones. While fURS offers better short-term stone clearance, SWL demonstrates comparable long-term efficacy with added QoL benefits.