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KMID : 0358320070480020171
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Korean Journal of Urology
2007 Volume.48 No. 2 p.171 ~ p.175
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Treatment of Upper and Mid Ureter Stones: Comparison of Semirigid Ureteroscopic Lithotripsy with Holmium: YAG Laser and Shock Wave Lithotripsy
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Kwon Yong-Uk
Lee Sang-Ik
Jeong Tae-Yoong
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Abstract
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Purpose: To compare the success rates, complications and cost effectiveness of extracorporeal shock wave lithotripsy(ESWL) and ureteroscopic lithotripsy(URS) using a Holmium: YAG laser to establish the more effective treatment for upper and mid ureter stones.
Materials & Methods: This retrospective study included 83 and 286 patients treated with URS and ESWL, respectively, for upper and mid ureter stones. URS was performed with a 7.5Fr semi-rigid ureterorenoscope and Holmium: YAG laser. ESWL was performed with Stonelith V.5 (PCK, Turkey). The stone sizes, success rates, postoperative complications and cost effectiveness were analyzed for each group.
Results: The overall success rates of the URS and ESWL were 97.6 and 82.5%, respectively. Success rates of URS were 98.4 and 95.2% when the stones were smaller and larger than 10mm, respectively. In the ESWL group, the success rates after the third session were 86.3 and 65.4% with stones smaller and larger than 10mm, respectively. The complication rates associated with URS and ESWL were 6 and 4.2%, respectively. The average cost of URS was lower than that of ESWL.
Conclusion: In our study, URS with Holmium: YAG laser was more efficacious than ESWL. Considering both the success rate and cost effectiveness, URS should remain the recommended first-line treatment for upper and mid ureter stones. (Korean J Urol 2007;48:171-175)
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KEYWORD
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Ureter stone, Extracorporeal shockwave lithotripsy, Ureteroscopy, Holmium
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