Nevzat Can Sener1, Okan Bas2, Emine Sener3, Kursad Zengin4, Ufuk Ozturk5, Adem Altunkol6, Yalcin Evliyaoglu6. 1. Department of Urology, Numune Teaching and Research Hospital, Yuregir, Adana, Turkey. Electronic address: cansener14@gmail.com. 2. Department of Urology, Onkoloji Education and Research Hospital, Ministry of Health, Ankara, Turkey. 3. Department of Radiology, Ceyhan State Hospital, Ceyhan, Adana, Turkey. 4. Department of Urology, Bozok University, Yozgat, Turkey. 5. Department of Urology, Diskapi Yildirim Beyazid Education and Research Hospital, Ministry of Health, Ankara, Turkey. 6. Department of Urology, Numune Teaching and Research Hospital, Yuregir, Adana, Turkey.
Abstract
OBJECTIVE: To present the outcomes of flexible ureteroscopy (F-URS), shock wave lithotripsy (SWL), and observation in the management of asymptomatic lower calyceal stones. METHODS: A total of 150 patients with asymptomatic lower calyceal stones were randomized into F-URS (group 1), SWL (group 2), and observation (group 3) groups. The main criteria for patient enrollment were having asymptomatic single lower pole stones <1 cm. RESULTS: In F-URS, the mean stone-free rate was 92% (46 of 50). The mean number of sessions for the SWL group was 1.48 ± 0.65. Stone-free rate was 90% (45 of 50). In the observation group, patients were followed up for a mean of 21.02 ± 3.65 months. Three stones passed spontaneously without any symptoms. Pain developed in 3 patients during follow-up, and 2 of them passed a stone and responded to analgesics without further treatment. Complication rates for groups 1 and 2 were similar, but group 2 had higher Clavien grades. CONCLUSION: For asymptomatic small-sized lower calyceal stones, SWL and F-URS are established treatment modalities. However, with low auxiliary treatment rates, observation may be an option for the management of nonsymptomatic small-sized lower pole kidney stones.
RCT Entities:
OBJECTIVE: To present the outcomes of flexible ureteroscopy (F-URS), shock wave lithotripsy (SWL), and observation in the management of asymptomatic lower calyceal stones. METHODS: A total of 150 patients with asymptomatic lower calyceal stones were randomized into F-URS (group 1), SWL (group 2), and observation (group 3) groups. The main criteria for patient enrollment were having asymptomatic single lower pole stones <1 cm. RESULTS: In F-URS, the mean stone-free rate was 92% (46 of 50). The mean number of sessions for the SWL group was 1.48 ± 0.65. Stone-free rate was 90% (45 of 50). In the observation group, patients were followed up for a mean of 21.02 ± 3.65 months. Three stones passed spontaneously without any symptoms. Pain developed in 3 patients during follow-up, and 2 of them passed a stone and responded to analgesics without further treatment. Complication rates for groups 1 and 2 were similar, but group 2 had higher Clavien grades. CONCLUSION: For asymptomatic small-sized lower calyceal stones, SWL and F-URS are established treatment modalities. However, with low auxiliary treatment rates, observation may be an option for the management of nonsymptomatic small-sized lower pole kidney stones.
Authors: G Bozzini; P Verze; D Arcaniolo; O Dal Piaz; N M Buffi; G Guazzoni; M Provenzano; B Osmolorskij; F Sanguedolce; E Montanari; N Macchione; K Pummer; V Mirone; M De Sio; G Taverna Journal: World J Urol Date: 2017-09-05 Impact factor: 4.226
Authors: Doo Yong Chung; Dong Hyuk Kang; Kang Su Cho; Won Sik Jeong; Hae Do Jung; Jong Kyou Kwon; Seon Heui Lee; Joo Yong Lee Journal: PLoS One Date: 2019-02-21 Impact factor: 3.240
Authors: Christian D Fankhauser; Thomas Hermanns; Laura Lieger; Olivia Diethelm; Martin Umbehr; Thomas Luginbühl; Tullio Sulser; Michael Müntener; Cédric Poyet Journal: Clin Kidney J Date: 2018-01-25