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Treatment of large impacted proximal ureteral stones: randomized comparison of minimally invasive percutaneous antegrade ureterolithotripsy versus retrograde ureterolithotripsy

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Abstract

Objective

To provide appropriate evidence for treatment planning of patients with an impacted proximal ureteral stones ≥1.5 cm in size, by analyzing the therapeutic outcomes for those undergoing minimally invasive percutaneous antegrade ureterolithotripsy and retrograde ureterolithotripsy.

Patients and methods

From September 2010 to November 2011, eligible patients with impacted proximal ureteral stones ≥1.5 cm in size referred to our institute were considered for this study. The closed envelope method was used to randomize the enrolled patients to mini-PCNL (30) or retrograde ureterolithotripsy (29). The efficiency quotient (EQ) was calculated to specifically address the efficiency for both the techniques. All preoperative and postoperative data for both groups were recorded.

Results

The initial stone-free rate was 93.3 % in the mini-PCNL group and 41.4 % in the URSL group (p < 0.001). However, the overall stone-free rate at the 1-month follow-up visit after initial treatment was 100 % in the mini-PCNL group and 89.7 % in the URSL group (p = 0.07). The EQs for the mini-PCNL and URSL groups were 0.83 and 0.50, respectively.

Conclusions

Our study shows that mini-PCNL removal of large impacted proximal ureteral calculi can achieve higher stone-free rates and safe.

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Conflict of interest

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Authors and Affiliations

  1. Department of Urology; The First Affiliated Hospital (Jiangsu Province Hospital of TCM), Nanjing University of Chinese Medicine, Nanjing, 210046, Jiangsu, China

    Gu Xiao-jian & Xu Yan

  2. Department of Urology, Affiliated Jiangning Hospital, Nanjing Medical University, Gushan Road 176, Nanjing, 211100, China

    Lu Jian Lin

Authors
  1. Gu Xiao-jian
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  2. Lu Jian Lin
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  3. Xu Yan
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Correspondence to Lu Jian Lin.

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Xiao-jian, G., Jian Lin, L. & Yan, X. Treatment of large impacted proximal ureteral stones: randomized comparison of minimally invasive percutaneous antegrade ureterolithotripsy versus retrograde ureterolithotripsy. World J Urol 31, 1605–1610 (2013). https://doi.org/10.1007/s00345-013-1026-2

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  • DOI: https://doi.org/10.1007/s00345-013-1026-2

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