Davide Arcaniolo1, Marco De Sio1, Jens Rassweiler2, Jilian Nicholas3, Estevão Lima4, Giuseppe Carrieri5, Evangelos Liatsikos6, Vincenzo Mirone7, Manoj Monga8, Riccardo Autorino9,10. 1. Urology Unit, Second University of Naples, Naples, Italy. 2. Department of Urology, SLK-Kliniken Heilbronn, Heilbronn, Germany. 3. University Hospitals Urology Institute, Case Western Reserve University, 27100 Chardon Rd, Richmond Heights, OH, 44143, USA. 4. Life and Health Sciences Research Institute, University of Minho, Braga, Portugal. 5. Department of Urology, University of Foggia, Foggia, Italy. 6. Department of Urology, University of Patras, Patras, Greece. 7. Department of Urology, Federico II University, Naples, Italy. 8. Glickman Urological Kidney Institute, Cleveland Clinic, Cleveland, USA. 9. Urology Unit, Second University of Naples, Naples, Italy. ricautor@gmail.com. 10. University Hospitals Urology Institute, Case Western Reserve University, 27100 Chardon Rd, Richmond Heights, OH, 44143, USA. ricautor@gmail.com.
Abstract
OBJECTIVE: To analyze the current evidence on the use of ureteroscopy (URS) and extracorporeal shock wave lithotripsy (ESWL) for the management of obstructing ureteral stones in emergent setting. METHODS: A systematic literature review was performed up to June 2016 using Pubmed and Ovid databases to identify pertinent studies. The PRISMA criteria were followed for article selection. Separate searches were done using a combinations of several search terms: "laser lithotripsy", "ureteroscopy", "extracorporeal shock wave lithotripsy", "ESWL", "rapid", "immediate", "early", "delayed", "late", "ureteral stones", "kidney stones", "renal stones". Only titles related to emergent/rapid/immediate/early (as viably defined in each study) versus delayed/late treatment of ureteral stones with either URS and/or ESWL were considered for screening. Demographics and operative outcomes were compared between emergent and delayed lithotripsy. RevMan review manager software was used to perform data analysis. RESULTS: Four studies comparing emergent (n = 526) versus delayed (n = 987) URS and six studies comparing emergent (n = 356) versus delayed (n = 355) SWL were included in the analysis. Emergent URS did not show any significant difference in terms of stone-free rate (91.2 versus 90.9%; OR 1.04; CI 0.71, 1.52; p = 0.84), complication rate (8.7% for emergent versus 11.5% for delayed; OR 0.94; CI 0.65, 1.36; p = 0.74) and need for auxiliary procedures (OR 0.85; CI 0.42, 1.7; p = 0.85) when compared to delayed URS. Emergent ESWL was associated with a higher likelihood of stone free status (OR 2.2; CI 1.55, 3.17; p < 0.001) and a lower likelihood of need for auxiliary maneuvers (OR 0.49; CI 0.33, 0.72; p < 0.001) than the delayed procedure. No differences in complication rates were noticed between the emergent and delayed ESWL (p = 0.37). CONCLUSIONS: Emergent lithotripsy, either ureteroscopic or extracorporeal, can be offered as an effective and safe treatment for patients with symptomatic ureteral stone. If amenable to ESWL, based on stone and patient characteristics, an emergent approach should be strongly considered. Ureteroscopy in the emergent setting is mostly reserved for distally located stones. The implementation of these therapeutic approaches is likely to be dictated by their availability.
OBJECTIVE: To analyze the current evidence on the use of ureteroscopy (URS) and extracorporeal shock wave lithotripsy (ESWL) for the management of obstructing ureteral stones in emergent setting. METHODS: A systematic literature review was performed up to June 2016 using Pubmed and Ovid databases to identify pertinent studies. The PRISMA criteria were followed for article selection. Separate searches were done using a combinations of several search terms: "laser lithotripsy", "ureteroscopy", "extracorporeal shock wave lithotripsy", "ESWL", "rapid", "immediate", "early", "delayed", "late", "ureteral stones", "kidney stones", "renal stones". Only titles related to emergent/rapid/immediate/early (as viably defined in each study) versus delayed/late treatment of ureteral stones with either URS and/or ESWL were considered for screening. Demographics and operative outcomes were compared between emergent and delayed lithotripsy. RevMan review manager software was used to perform data analysis. RESULTS: Four studies comparing emergent (n = 526) versus delayed (n = 987) URS and six studies comparing emergent (n = 356) versus delayed (n = 355) SWL were included in the analysis. Emergent URS did not show any significant difference in terms of stone-free rate (91.2 versus 90.9%; OR 1.04; CI 0.71, 1.52; p = 0.84), complication rate (8.7% for emergent versus 11.5% for delayed; OR 0.94; CI 0.65, 1.36; p = 0.74) and need for auxiliary procedures (OR 0.85; CI 0.42, 1.7; p = 0.85) when compared to delayed URS. Emergent ESWL was associated with a higher likelihood of stone free status (OR 2.2; CI 1.55, 3.17; p < 0.001) and a lower likelihood of need for auxiliary maneuvers (OR 0.49; CI 0.33, 0.72; p < 0.001) than the delayed procedure. No differences in complication rates were noticed between the emergent and delayed ESWL (p = 0.37). CONCLUSIONS: Emergent lithotripsy, either ureteroscopic or extracorporeal, can be offered as an effective and safe treatment for patients with symptomatic ureteral stone. If amenable to ESWL, based on stone and patient characteristics, an emergent approach should be strongly considered. Ureteroscopy in the emergent setting is mostly reserved for distally located stones. The implementation of these therapeutic approaches is likely to be dictated by their availability.
Authors: Mohammed A Al-Ghazo; Ibrahim Fathi Ghalayini; Rami S Al-Azab; Osamah Bani Hani; Ibrahim Bani-Hani; Mohammad Abuharfil; Yazan Haddad Journal: Urol Res Date: 2011-04-17
Authors: Yousef S Matani; Mohammed A Al-Ghazo; Rami S Al-Azab; Osamah Bani Hani; Ibrahim F Ghalayini; Ibrahim Bani Hani Journal: Can Urol Assoc J Date: 2013 Jul-Aug Impact factor: 1.862
Authors: Christian Türk; Aleš Petřík; Kemal Sarica; Christian Seitz; Andreas Skolarikos; Michael Straub; Thomas Knoll Journal: Eur Urol Date: 2015-09-04 Impact factor: 20.096
Authors: Abdullatif Al-Terki; Majd Alkabbani; Talal A Alenezi; Tariq F Al-Shaiji; Shabir Al-Mousawi; Ahmed R El-Nahas Journal: Arab J Urol Date: 2020-08-25
Authors: Roman Herout; Martin Baunacke; Christer Groeben; Cem Aksoy; Björn Volkmer; Marcel Schmidt; Nicole Eisenmenger; Rainer Koch; Sven Oehlschläger; Christian Thomas; Johannes Huber Journal: World J Urol Date: 2021-08-28 Impact factor: 4.226
Authors: Selçuk Güven; Mehmet Giray Sönmez; Bhaskar Kumar Somani; Ali Serdar Gözen; Kemal Sarica; Juan Gómez Rivas; Udo Nagele; Theodoros Tokas Journal: Cent European J Urol Date: 2022-05-05
Authors: Adel Kurkar; Ahmad A Elderwy; Mahmoud M Osman; Islam F Abdelkawi; Mahmoud M Shalaby; Mohamed F Abdelhafez Journal: Urolithiasis Date: 2022-06-03 Impact factor: 2.861