COMPARISON OF EXTRA-CORPOREAL SHOCK WAVE LITHOTRIPSY VERSUS URETEROSCOPIC HOLMIUM: YAG LASER LITHOTRIPSY FOR PROXIMAL URETERAL CALCULI. A RCT AT TERTIARY CARE CENTRE

ABSTRACT
Objective: To compare the efficacy of laser ureteroscopic lithotripsy versus extracorporeal shockwave lithotripsy in the
treatment of proximal ureteral stones of size between 10mm to 15mm.
Material and Methods:
This study was conducted in the Institute of Kidney Diseases, Hayatabad, Peshawar from May, 2012 to April, 2016. This
study is randomized controlled trial. Two hundred and eighty-two patients with 10 – 15 mm proximal ureteric stone,
one group were treated with ESWL and second with ureterorenoscopic manipulation by using an 8.0 or 8.5 Fr semi
rigid ureteroscope. Intracorporeal lithotripsy was performed by using Ho: YAG laser. The stone free rate was compared
between groups by considering size of stone at two weeks after procedure.
Results: Stone clearance among patients undergoing ESWL was effective in 68.8% (n=97) while in the URSL group
80.85% (n=114) were treated successfully.
Conclusion: Both Laser URSL & ESWL are well accepted minimally invasive modalities of treatment for proximal
ureteric stones. We conclude that Laser URSL in the treatment of patients with proximal ureteric stones has yielded
superior results as compared to the ESWL group in treatment of patients with proximal ureteric stones of size 1-1.5cm.
Key words: ESWL, URSL, Ureteric Stone etc.