A COMPARISON OF URETEROSCOPY WITH SUPINE-TRANS-GLUTEAL EXTRA-CORPOREAL SHOCK-WAVE LITHOTRIPSY FOR THE MANAGEMENT OF DISTAL URETERIC CALCULUS.

Abstract

Background: Uro-lithiasis is one of the most frequent urological disorders seen on a daily basis. Ureterorenoscopic Lithotripsy has traditionally been used to treat distal ureteric calculus (URSL). Extra-corporeal Shock-wave Lithotripsy (ESWL) using a trans-gluteal route has recently been investigated.

Aims & objectives: The goal of this study is to see how supine trans-gluteal ESWL works on distal ureteric calculus and compare it to semi-rigid ureterorenoscopy in the management of distal ureteric calculus.

Material & methods: A total of 240 subjects were included in our trial, which lasted a year and was randomly separated into two categories by an independent observer. After collecting consents, taking a full history and doing clinical examinations as needed, and conducting the necessary biochemical and radiological studies, Category A was offered ESWL while Category B was offered URSL. After 15 days after the procedure, the subjects were followed up on.

Results: Many subjects, especially the elderly, obese, and those with physical disabilities or poor mobility, prefer the supine posture SWL. When the patient and calculus characteristics were compared, there was no discernible difference between the two categories. In both categories, males make up the bulk of the subjects (82 percent). The supine trans-gluteal SWL category had an 89 percent calculus-free rate.

Conclusion:  We conclude that ESWL management has a low morbidity and high effectiveness, and that the results are comparable to those of uretero-scopy with intra-corporeal lithotripsy, with the added benefits of an outpatient operation, no need for anaesthesia, and the use of DJ stents.

Keywords: Distal Ureteric Calculus, URSL, Trans-gluteal ESWL, Calculus clearance.