A multicenter, randomized, controlled trial of transureteral and shock wave Lithotripsy-Which is the best minimally invasive modality to treat distal ureteral calculi in children?

Abbas Basiri, Samad Zare, Ali Tabibi, Farzaneh Sharifiaghdas, Alireza Aminsharifi, Seyed Habibollah Mousavi-Bahar, Hassan Ahmadnia

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Purpose: Since there is insufficient evidence to determine the best treatment modality in children with distal ureteral calculi, we designed a multicenter, randomized, controlled trial to evaluate the efficacy and complications of transureteral and shock wave lithotripsy in these patients. Materials and Methods: A total of 100 children with distal ureteral calculi were included in the study. Of the patients 50 were randomized consecutively to undergo shock wave lithotripsy using a Compact Delta II lithotriptor (Dornier MedTech, Kennesaw, Georgia), and 50 were randomized to undergo transureteral lithotripsy with holmium laser and pneumatic lithotriptor between February 2007 and October 2009. Stone-free, complication and efficiency quotient rates were assessed in each group. Results: Mean ± SD patient age was 6.5 ± 3.7 years (range 1 to 13). Mean stone surface was 35 mm2 in the transureteral group and 37 mm2 in the shock wave lithotripsy group. Stone-free rates at 2 weeks after transureteral lithotripsy and single session shock wave lithotripsy differed significantly, at 78% and 56%, respectively (p = 0.004). With 2 sessions of shock wave lithotripsy the stone-free rate increased to 72%. Efficiency quotient was significantly higher for transureteral vs shock wave lithotripsy (81% vs 62%, p = 0.001). Minor complications were comparable and negligible between the groups. Two patients (4%) who underwent transureteral lithotripsy sustained a ureteral perforation. Conclusions: In the short term it seems that transureteral and shock wave lithotripsy are acceptable modalities for the treatment of distal ureteral calculi in children. However, transureteral lithotripsy has a higher efficacy rate when performed meticulously by experienced hands using appropriate instruments.

Original languageEnglish (US)
Pages (from-to)1106-1109
Number of pages4
JournalJournal of Urology
Volume184
Issue number3
DOIs
StatePublished - Sep 2010

All Science Journal Classification (ASJC) codes

  • Urology

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