Comparison of successful treatment between ureteroscopic lithotripsy and extracorporeal shock wave lithotripsy for proximal ureteric calculi

Objective: To compare the stone free rate between ureteroscopic lithotripsy (URSL) and extracorporeal shock wave lithotripsy (SWL) for proximal ureteric calculi (UC). Material and Method: Between February 2010 and June 2015, patients who underwent URSL with semi-rigid 6.5/7 Fr(Wolf.)™ with Lumenis Versa Pulse Holmium: YAG laser or SWL with Dornier compact Delta for proximal UC <2 cm were reviewed. The data included demographic, perioperative status, stone free, and retreatment rate. To compare these two modalities of treatment, statistical analysis was calculated by Chi-square and independent-T test. Results: Total of 150 patients were included. 75 patients underwent URSL (mean stone burden was 9.77 mm) while another 75 patients underwent SWL (mean stone burden was 9.06 mm). The stone free rate was 85.3% in URSL group vs. 44% in SWL (p<0.001). 4/75 patients (5.3%) in URSL group required more than one procedure, 17/75 patients (22.7%) in SWL group required re-treatment (p<0.001). The complications of these two modalities were infection, stone migration, and hematuria while urosepsis, ureter stricture, and ureteric perforation were found only in the URSL group; 4%, 2.7% and 1.3% respectively. Whereas steinstrasse (5.3%) and renal colic (2.7%) were found only in SWL group. Conclusions: URSL is an effective treatment for proximal ureteric calculi <2 cm which had better outcomes in term of stone free and less re-treatment.