Clinical Comparative Analysis Between Emergency Ureteroscopy Lithotripsy And Extracorporeal Shock Wave Lithotripsy In Management Of Ureteral Calculi With Acute Renal Colic

Objective:To compare the efficacy and complication of extracorporeal shock wave lithotripsy(ESWL) and emergency ureteroscopy pneumatic lithotripsy(URSL) in the management of ureteral calculi with acute renal colic. Methods:68cases with urcteral calculi were treated with emergency URSL(URSL group) and80cases with ureteral calculi were treated with ESWL (ESWL group). Clinical data of two groups, which came from our hospital the last two years, were analyzed retrospectively. Compare the success rate of lithotripsy, pain release, clearance rate of stones after two weeks, Re-treatment rate and complication incidence of the two groups. Results:The success rates of postoperative pain release(95.59%), disposable lithotripsy(92.65%), clearance of stones after two weeks(94.12%) in URSL group were higher than that in ESWL group (76.25%,75.00%,77.50%,respectively,P<0.05).The re-treatment rate in URSL group (10.29%)were lower than that in ESWL group(33.75%, P<0.05). There is no significant statistical difference between two groups in complication, such as macroscopic haematuria, ureter perforation, ureter tear, fever, urinary tract infection and so on(P>0.05). According to the analysis of the location and size of stones,we can see that there is also no significant statistical difference between two groups on upper ureteral calculi and5-10mm in diameter.in complication and the rate of disposable lithotripsy,clearance of stones after two weeks(P>0.05).At the same time,the success rates of postoperative pain release, disposable lithotripsy, clearance of stones after two weeks in URSL group on the middle or lower ureteral calculi and diameter greater than10mm, were higher than that in ESWL group.In addition,the re-treatment rate were lower than that in ESWL group. Conclusion: Emergency ESWL and URSL for the patients, who suffered from ureteral calculi associated with acute renal colic after spasmolysis and analgesia drug ineffective treatment, is effective and safe treatment. For calculi in upper ureter and its diameter between5-10mm, emergency ESWL can be the first choice; so preferred ureteroscopy surgery has a certain clinical value of popularization in management of those stones, which are in the middle or lower ureteral and longer than10mm in their diameter.