TO DETERMINE THE STONE CLEARANCE RATE AFTER ESWL VERSUS URSL IN PATIENTS OF UPPER URETERAL STONES HAVING STONE SIZE <15 MM

Background: Urolithiasis is an extremely common health condition, with a reported incidence ranging from 11% to 13% of men and 5.6% to 7.0% in women by the age of 70 years. The most common symptoms of ureteral stones are pain, vomiting and hematuria.

Objective: To determine the stone clearance rate after ESWL versus URSL in patients of upper ureteral stones having stone size <15 mm.

Study Design: Randomized Clinical Trail.

Setting: The study was conducted at department of Urology, Sindh Institute of Urology and Transplantation (SIUT) Karachi.

Duration of Study: 7-June-2020 to 6-Dec-2020.

Patients and Methods:      A total number of 76 patients with diagnosis of upper ureteral stones having age 20 to 70 years were included in this study. There were 38 patients in URSL group and 38 patients in ESWL group. URSL was done using a rigid uretero-scope. ESWL was performed in prone position using an electromagnetic lithotripter under fluoroscopic or ultrasound guidance. Post-procedural X-ray KUB was done one week after the surgical procedure to determine the stone clearance in every patient.

Results: The mean age of patients in this study was 46.60+10.83 years. There were 47 (61.84%) male patients and 29 (38.16%) female patients. There were 17 (22.37%) patients who were having hypertension and 12 (15.79%) patients having diabetes mellitus. complete stone clearance occurred in 35 (92.1%) patients in URSL group and in 30 (78.90%) patients in ESWL group (P-value 0.10).

Conclusion: Ureteroscopic lithotripsy (URSL) is a better management option as compare to extra-corporeal shockwave lithotripsy (ESWL) for management of proximal ureteral stones.

Keywords: Ureteral stones, Extracorporeal shockwave lithotripsy (ESWL), Ureteroscopic lithotripsy (URSL).