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 mm(2) in the transureteral group and 37 mm(2) 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. 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
RCT Entities:
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 mm(2) in the transureteral group and 37 mm(2) 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. 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Authors: Jason Y Lee; Sero Andonian; Naeem Bhojani; Jennifer Bjazevic; Ben H Chew; Shubha De; Hazem Elmansy; Andrea G Lantz-Powers; Kenneth T Pace; Trevor D Schuler; Rajiv K Singal; Peter Wang; Michael Ordon Journal: Can Urol Assoc J Date: 2021-12 Impact factor: 1.862
Authors: Michael E Chua; Jin Kyu Kim; Jessica M Ming; Keara N De Cotiis; Stephen S Yang; Mandy Rickard; Armando J Lorenzo; Joana Dos Santos Journal: Pediatr Surg Int Date: 2022-08-08 Impact factor: 2.003