Comparative Analysis of the Efficacy of Extracorporeal Shockwave Lithotripsy vs. Ureteroscopy on Ureterovesical Junction Stones After Failed Medical Expulsive Therapy
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Keywords

extracorporeal shockwave lithotripsy
ureteroscopy
ureterovesical junction stones

How to Cite

Alonzo, J. I., Bolong, D., & Santos, J. (2020). Comparative Analysis of the Efficacy of Extracorporeal Shockwave Lithotripsy vs. Ureteroscopy on Ureterovesical Junction Stones After Failed Medical Expulsive Therapy. Philippine Journal of Urology, 26(2), 49-52. Retrieved from https://pjuonline.com/index.php/pju/article/view/23

Abstract

Objective: The study aimed to determine the stone-free rate (SFR) of Extracorporeal Shockwave Lithotripsy (ESWL) on Ureterovesical Junction (UVJ) stones which failed to resolve after Medical Expulsive Therapy (MET.) The SFR of ESWL for UVJ stones is compared to that of Ureteroscopy in order to assess the efficacy of ESWL.

Methods: This is a pilot case-series which utilized patient charts from UST Hospital and Manila Lithotriptors, Inc. from January 2010 to August 2015 with UVJ stones that failed to resolve after 2 weeks of MET. These patients subsequently underwent either ESWL or URS for active management of UVJ stones. Stone-free status was determined on 2-week follow-up using repeat imaging. Patient demographics and stone-free rates were subjected to statistical analysis. Patient age and stone size were tested for normal distribution using Shapiro-Wilk test. T-test for two-sample assuming equal variances was used to test for the significance of any noted difference. Data on gender were analyzed using Fisher Exact Probability Test.

Results: Nineteen patients fulfilled the inclusion criteria of this study. Seven patients underwent ESWL while 12 patients underwent URS. No statistical significance was observed for patients’ age and gender. There was a significant difference in mean stone size between the two groups; 0.5 cm for ESWL and 0.7 cm for URS. Stone-free rates of ESWL and URS were 85.7% and 83.3%, respectively. Fisher Exact Probability test revealed no significant difference in SFR between the 2 groups. In addition, there was poor correlation between stone free rate and the type of procedure done.

Conclusion: Extracorporeal shockwave lithotripsy is a viable option in treating UVJ stones after failed MET with a SFR of 85.7%. In comparison to URS, there is no significant difference with ESWL for UVJ stones in terms of stone-free rates.

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