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Shock wave lithotripsy versus endoscopic cystolitholapaxy in the management of patients presenting with calcular acute urinary retention: a randomised controlled trial

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Abstract

Purpose

Shock wave lithotripsy (SWL) in treatment of bladder and urethral stones was not precisely determined. The objective of this study is to compare the efficacy and safety of SWL versus visual cystolitholapaxy in the management of calcular acute urine retention.

Methods

From March 2015 to February 2017, a randomised controlled study was conducted on 100 patients for whom urethral catheter fixed for acute retention of urine due to urethral or vesical radio-opaque stone(s) ≤ 2 cm. Patients were randomised to either SWL group (n = 50) or visual cystolitholapaxy (endoscopy group) (n = 50).

Results

No statistically significant differences between the pre-operative parameters of both groups were found. The mean stone diameter was 12.2 ± 3 mm and 12.2 ± 3.2 mm in SWL and endoscopy groups, respectively (p value = 0.4). The overall success rates of SWL group were 94% (47 of 50 patients) and endoscopy group were 98% (49 of 50 patients). SWL failed in 3 patients (6%); these 3 patients underwent cystolitholapaxy and were rendered free of stones. Intra-operative and post-operative complications were comparable between both groups (p value = 0.5 and 1, respectively). One patient had bladder perforation in the endoscopy group and was managed conservatively.

Conclusions

SWL mono-therapy is safe, non-invasive and as effective as visual cystolitholapaxy in management of patients presenting with acute urine retention by vesical or urethral stones 2 cm or less and could be useful for patients unwilling/unfit for general anaesthesia.

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Authors and Affiliations

  1. Urology and Nephrology Center, Mansoura University, Mansoura, Egypt

    Mohamed Ali, Abdelwahab Hashem, Tamer E. Helmy, Tamer Zewin, Khaled Z. Sheir & Ahmed A. Shokeir

Authors
  1. Mohamed Ali
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  2. Abdelwahab Hashem
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  3. Tamer E. Helmy
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  4. Tamer Zewin
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  5. Khaled Z. Sheir
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  6. Ahmed A. Shokeir
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Contributions

Ali M: patients’ follow-up, data collection and manuscript writing. Hashem A: manuscript re-writing, revision and editing. Helmy T: supervision on patients’ follow-up and data collection and manuscript revision. Zewin T: patients follow-up and protocol writing. Sheir KZ: SWL session supervision and statistical analysis. Shokier AA: study chief and supervision of study and manuscript revision.

Corresponding author

Correspondence to Abdelwahab Hashem.

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The authors declare that they have no conflict of interest.

Human and animal rights

All procedures in this study involving human participants were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Ali, M., Hashem, A., Helmy, T.E. et al. Shock wave lithotripsy versus endoscopic cystolitholapaxy in the management of patients presenting with calcular acute urinary retention: a randomised controlled trial. World J Urol 37, 879–884 (2019). https://doi.org/10.1007/s00345-018-2434-0

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  • DOI: https://doi.org/10.1007/s00345-018-2434-0

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