Evaluating the Effectiveness of Shockwave Lithotripsy vs Ureteroscopic Lithotripsy for Treatment of Renal Stones: A Prospective Cohort Study.

BACKGROUND

Renal stones are a prevalent condition requiring effective treatment strategies. This study evaluates the comparative effectiveness of shockwave lithotripsy (SWL) and ureteroscopic lithotripsy (URSL) in treating renal stones in a Pakistani cohort, focusing on stone clearance, recurrence, and complications.

METHODS

This prospective cohort study involved 250 patients aged 18-55 diagnosed with renal stones. Participants were divided into two groups based on treatment selection (SWL or URSL) and followed for 12 months. Primary outcomes included stone clearance rates, while secondary outcomes encompassed recurrence and complications. Statistical analyses, including chi-square tests and Mann-Whitney U tests, assessed demographic and clinical characteristics, with significance set at p < 0.05.

RESULTS

The mean age of participants was 35.05 years, with an equal distribution between SWL and URSL groups. Both treatments demonstrated similar stone clearance rates, with no significant difference in success (p > 0.05). Complications were noted in 64.4% of cases, with bleeding (34.0%) and infection (30.4%) as the most frequent issues. Recurrence rates were comparable (p = 0.800), affecting 49.2% of patients. Re-treatment was required in 51.2% of cases, equally distributed between the groups.

CONCLUSION

SWL and URSL exhibit comparable effectiveness in treating renal stones, with similar success and recurrence rates. While complications were common, they were manageable. Both approaches are effective options for renal stone management, emphasizing the need for individualized treatment decisions based on patient and stone characteristics.