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Is flexible ureterorenoscopy and laser lithotripsy the new gold standard for lower pole renal stones when compared to shock wave lithotripsy: Comparative outcomes from a University hospital over similar time period

Is flexible ureterorenoscopy and laser lithotripsy the new gold standard for lower pole renal stones when compared to shock wave lithotripsy: Comparative outcomes from a University hospital over similar time period
Is flexible ureterorenoscopy and laser lithotripsy the new gold standard for lower pole renal stones when compared to shock wave lithotripsy: Comparative outcomes from a University hospital over similar time period

INTRODUCTION: Renal lower pole stones pose difficulty in management due to anatomical variation, stone size, hardness and patient demographics. Flexible ureterorenoscopy and laser lithotripsy (FURSL) and shock wave lithotripsy (SWL) are preferred for stones 1-2 cm in size. We wanted to compare the outcomes of FURSL and SWL for lower pole stones during the same time period.

MATERIAL AND METHODS: All patients who were treated for lower pole stones with FURSL and SWL during a 19-month period were included. The stone free rate (SFR) was defined as ≤3 mm fragments on follow-up imaging or stone free endoscopically. Data was recorded in an excel spreadsheet with SPSS version 21 used for statistical analysis.

RESULTS: A total of 161 lower pole procedures were done (93 SWL and 63 FURSL). The mean stone size for SWL (7.4 mm; range: 4-16 mm) was significantly smaller than for FURSL (13.4 mm; 4-53 mm). The mean operating time and hospital stay for FURSL was 65 minutes (range: 30-160 minutes) and 0.5 days (range: 0-7 days) respectively. The SFR was significantly better (p <0.001) for FURSL (n = 63, 93%) compared to SWL (n = 23, 25%). There were 4 (6%) complications (3 Clavien II and 1 Clavien I) in the FURSL group (2 urosepsis, 1 UTI and 1 stent pain). Three patients in the SWL group (Clavien I) were readmitted with renal colic but there were no other complications.

CONCLUSIONS: FURSL for lower pole stones seems to be a much better alternative than SWL with a high SFR even for larger stones and seems to be the new gold standard for lower pole stone management.

Journal Article
2080-4806
183-186
Burr, Jacob
0fce8a6d-c224-49fa-8b6f-3da29e02f7b2
Ishii, Hiro
d2dd0ce3-0ccd-4cb4-8aa1-f6d363e29b90
Simmonds, Nick
58a64ec9-199d-4113-aa23-8a60f1b41b09
Somani, Bhaskar K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Burr, Jacob
0fce8a6d-c224-49fa-8b6f-3da29e02f7b2
Ishii, Hiro
d2dd0ce3-0ccd-4cb4-8aa1-f6d363e29b90
Simmonds, Nick
58a64ec9-199d-4113-aa23-8a60f1b41b09
Somani, Bhaskar K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9

Burr, Jacob, Ishii, Hiro, Simmonds, Nick and Somani, Bhaskar K. (2015) Is flexible ureterorenoscopy and laser lithotripsy the new gold standard for lower pole renal stones when compared to shock wave lithotripsy: Comparative outcomes from a University hospital over similar time period. Central European Journal of Urology, 68 (2), 183-186. (doi:10.5173/ceju.2015.509).

Record type: Article

Abstract

INTRODUCTION: Renal lower pole stones pose difficulty in management due to anatomical variation, stone size, hardness and patient demographics. Flexible ureterorenoscopy and laser lithotripsy (FURSL) and shock wave lithotripsy (SWL) are preferred for stones 1-2 cm in size. We wanted to compare the outcomes of FURSL and SWL for lower pole stones during the same time period.

MATERIAL AND METHODS: All patients who were treated for lower pole stones with FURSL and SWL during a 19-month period were included. The stone free rate (SFR) was defined as ≤3 mm fragments on follow-up imaging or stone free endoscopically. Data was recorded in an excel spreadsheet with SPSS version 21 used for statistical analysis.

RESULTS: A total of 161 lower pole procedures were done (93 SWL and 63 FURSL). The mean stone size for SWL (7.4 mm; range: 4-16 mm) was significantly smaller than for FURSL (13.4 mm; 4-53 mm). The mean operating time and hospital stay for FURSL was 65 minutes (range: 30-160 minutes) and 0.5 days (range: 0-7 days) respectively. The SFR was significantly better (p <0.001) for FURSL (n = 63, 93%) compared to SWL (n = 23, 25%). There were 4 (6%) complications (3 Clavien II and 1 Clavien I) in the FURSL group (2 urosepsis, 1 UTI and 1 stent pain). Three patients in the SWL group (Clavien I) were readmitted with renal colic but there were no other complications.

CONCLUSIONS: FURSL for lower pole stones seems to be a much better alternative than SWL with a high SFR even for larger stones and seems to be the new gold standard for lower pole stone management.

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More information

Accepted/In Press date: 5 February 2015
e-pub ahead of print date: 9 March 2015
Published date: 2015
Keywords: Journal Article

Identifiers

Local EPrints ID: 419372
URI: http://eprints.soton.ac.uk/id/eprint/419372
ISSN: 2080-4806
PURE UUID: e0d1c545-0c58-490b-bcd9-4b3fefd5c4b8

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Date deposited: 11 Apr 2018 16:30
Last modified: 20 Mar 2020 17:31

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