Role of Extracorporeal Shock Wave Lithotripsy in Management of Upper Ureteric Stones

Abstract

Introduction: The treatment options for upper ureteric stones range from open surgeries to minimally invasive and non invasive techniques. Presently the two most frequently used options for upper ureteric calculi that require intervention are extracorporeal shock wave lithotripsy (ESWL) and ureterorenoscopy (URS) with contact lithotripsy applied by attaining endoscopic access to the calculi. Objective: The objective of this study is meant to evaluate ESWL in the treatment of upper ureteric stones ≤2 cm in terms of stone free rates, complications and procedure time. Patients and method: Seventy six patients were subjected to ESWL as primary modality for treatment of upper ureteric stone. ESWL group had mean stone size of 10.58 mm. The stone free rate was 93.4% for ESWL. The sample size was adequate as it was determined by statistician by applying pertinent formulas. Results: It was observed that the stone free rate in ESWL group was higher (97.7%) when the stone size was ≤10 mm and when the duration of symptoms was <1 month. ESWL was advantageous in terms of procedural time with no requirement of anaesthesia. The complications in ESWL were minor in nature and were not statistically significant. Conclusion: In conclusion, this study shows that ESWL is an important modality in treating upper ureteric calculi ≤2 cm in size and we strongly recommend ESWL as the first choice of procedure in solitary upper ureteric calculi ≤10 mm size. Keywords: Extracorporeal shock wave lithotripsy, Ureterorenoscopy, Upper ureteric calculus