Extracorporeal shock wave lithotripsy and Ureterorenoscopy with pneumatic lithotripsy in the management of Impacted Upper ureteric calculus – A comparative study

Dr.T.Gnanasekaran; Dr.P.Vijayakumar

Volume : IX, Issue : IV, April - 2019

Extracorporeal shock wave lithotripsy and Ureterorenoscopy with pneumatic lithotripsy in the management of Impacted Upper ureteric calculus – A comparative study

Dr. T. Gnanasekaran, Dr. P. Vijayakumar

Abstract :

INTRODUCTION: Ureteric calculus is the common health problem affects all the age group Upper ureteric calculus disease is usually managed with Ureterorenoscopy and Intracorporeal lithotripsy or Extracorporeal shock wave lithotripsy. No proper guidelines available for the management of Impacted Ureteric calculus. AIM OF STUDY: To compare the efficacy of Insitu Extracorporeal lithotripsy and Ureterorenoscopy with Intracorporeal lithotripsy. MATERIALS AND METHODS: Total no of patients 43, were divided into 2 groups Group A: 22 patients underwent Ureterorenoscopy and Group B: 21 patients Underwent Insitu Extracorporeal lithotripsy. Patients followed up till stone clearance. RESULTS: There was no difference in the age and stone size between Ureterorenoscopy and Extracorporeal lithotripsy group. Success rate in URS & Intra corporeal pneumatic lithotripsy was 72.7% and in ESWL was 57.1%. Failure in URS was 27.2%, and in ESWL was 42.8%. Overall success rate in URS was 75.8%. DISCUSSION: Ideal management of impacted ureteric calculus is still controversial. Though Extracorporeal lithotripsy (ESWL) is accepted as first line of treatment for most upper urinary tract stones, results are not predictable in Impacted upper ureteric calculus. CONCLUSION: Insitu ESWL for impacted upper ureteric calculus might not be as successful as expected. Ureterorenoscopy with pneumatic lithotripsy inexperienced hands has very satisfactory results, when Holmium laser not available