부산대학교 도서관

BACKGROUND & OBJECTIVE: Urolithiasis remains a predominant health challenge, especially in regions like Pakistan where the prevalence of ureteric stones is substantial. With advancements in endourological stone management, the debate over the most effective therapeutic modality for proximal ureteric stones persists. This study aimed to provide insights by comparing the efficacy of Ureterorenoscopy (URS) and Extracorporeal Shock Wave Lithotripsy (ESWL) in managing these stones. METHODOLOGY: This controlled and experimental study spanned six months in 2022 at Karachi's Sindh Hospital of Urology and Transplantation. Total 60 participants, each diagnosed with a single IVU-detected radio-opaque proximal ureter stone, were enrolled. Random allocation was employed, assigning 30 patients to the URS group and 30 to the ESWL group. Follow-ups were conducted using x-ray KUB after three weeks, and data compilation utilized a computerized, pre-structured proforma. RESULTS: The mean age of participants was 27.58 years, with a majority being male. URS demonstrated remarkable efficacy, particularly in the age group of 21-30, where it showed a 100% success rate compared to ESWL's 44.4% (p=0.001). In females with stone sizes between 10-12mm, URS maintained a 100% efficacy, outperforming ESWL, which had a 44.4% efficacy (p=0.0005). Hospital stay duration also influenced outcomes: for stays ≤3 days, URS exhibited a 91.3% efficacy, surpassing ESWL's 68.4% (p=0.011). CONCLUSION: URS consistently exhibited superior efficacy in managing proximal ureteric stones across varied demographics and clinical parameters. This research substantiates URS as a more effective therapeutic option compared to ESWL for certain patient cohorts. [ABSTRACT FROM AUTHOR]