하부요관결석에서 응급 요관경하배석술의 유용성
Effectiveness of Emergency Ureterorenoscopic Lithotripsy for Distal Ureter Stones
Purpose: We performed this study to determine the efficacy between the use of emergency ureterorenoscopic lithotripsy(URSL) and emergency shock wave lithotripsy(SWL) for distal ureter stones in terms of stone-free rates, complication rates and patient satisfaction.Materials and Methods: This prospective study included 145 patients with distal ureter stones who underwent emergency URSL(URSL group, n=64) and emergency SWL(SWL group, n=81). All emergency URSL and SWL procedures were performed within eight hours of admission. Stone status was evaluated with either an intravenous pyelogram or the use of non- enhanced CT. URSL was performed with 7.5 Fr semi-rigid ureterorenosope and SWL was performed with Sonolith PRACTIS V.5.0(EDAP TECHNOMED). The stone-free rates, complication rates, visual analogue pain scale and patient satisfaction scores were analyzed for each group of patients.Results: The overall stone-free rates of the URSL and SWL group of patients at two weeks were 96.8% and 74%, respectively(p=0.001). Complication rates were similar(28.1% versus 27.1%, p=0.897). The patient satisfaction score was statistically significant in favor of patients that underwent emergency URSL.Conclusions: In our single-center study, treatment with emergency URSL provided higher stone-free rates and superior patient satisfaction, as compared with treatment with emergency SWL. Emergency URSL was considered as attractive modality for the management of distal ureter stones. (Korean J Urol 2008;49:257-261)
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