A comparative study on management of proximal ureteric calculus by ureterolithotripsy versus push-percutaneous nephrolithotomy

Author: 
Rajesh Kannaiyan., Ezhil Sundar V and Saravanan Kanakasabapathy

Introduction: Urinary stone disease, a significant problem in developing countries like India. The lifetime risk of development of urolithiasis in Asia 5-9%, lesser than western world. Although various non-invasive, minimally invasive endoscopy and open surgical methods available for stone disease, management of proximal ureteric calculus poses much challenge in its complete clearance. Materials and methods: We compared the outcome of ureterolithotripsy and push-percutaneous antegrade access in the management of proximal ureteric calculus >1.5cm. After getting the informed written consent, patient’s demographic data, clinical presentation, radiological findings were noted in a pro forma and assigned based on inclusion criteria to groups. Results: The two groups were comparable in age, sex, stone burden and in stone attenuation values. The mean operating time and mean hemoglobin drop were less in Ureterolithotripsy group and it is significant. The stone clearance rate at 3rd week was higher in Push-Percutaneous nephrolithotomy group 17(85%) than Ureterolithotripsy group 9(45%) (P=0.00). Discussion: The stone clearance rate was higher in Push- Percutaneous nephrolithotomy group than Ureterolithotripsy group, which was lower but comparable to other studies. Conclusion: Push-percutaneous nephrolithotomy, a reasonable option in patients with proximal ureteric calculus of size more than 15mm.

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DOI: 
DOI: http://dx.doi.org/10.24327/ijcar.2017.4087.0435
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