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. 2010 Nov;51(11):788-93.
doi: 10.4111/kju.2010.51.11.788. Epub 2010 Nov 17.

Comparison of Patient Satisfaction with Treatment Outcomes between Ureteroscopy and Shock Wave Lithotripsy for Proximal Ureteral Stones

Jong-Hyun Lee  1 , Seung Hyo Woo, Eun Tak Kim, Dae Kyung Kim, Jinsung Park
Affiliations

Comparison of Patient Satisfaction with Treatment Outcomes between Ureteroscopy and Shock Wave Lithotripsy for Proximal Ureteral Stones

Jong-Hyun Lee et al. Korean J Urol. 2010 Nov.

Abstract

Purpose: We examined patient satisfaction with treatment outcomes after shock wave lithotripsy (SWL) and ureteroscopic removal of stone (URS) for proximal ureteral stones.

Materials and methods: We evaluated 224 consecutive patients who underwent SWL (n=156) or URS (n=68) for a single radiopaque proximal ureteral stone. Stone-free rates, defined as no visible fragment on a plain X-ray; complications; and patient satisfaction were compared. Patient satisfaction was examined through a specifically tailored questionnaire that included overall satisfaction (5 scales) and 4 domains (pain, voiding symptoms, cost, and stone-free status).

Results: The stone-free rates after the first, second, and third sessions of SWL were 36.5%, 65.4%, and 84.6%, respectively. The overall stone-free rate of URS was 82.4%, which was comparable to that of the third session of SWL. Complications were similar between the two groups except for greater steinstrasse in the SWL group. Overall satisfaction and voiding symptoms, cost, and stone-free status showed no significant difference between the groups. In the pain domain, the SWL group had a relatively lower satisfaction rate than did the URS group (p=0.05). Subanalysis showed that the satisfaction rate of the URS group with stone-free status was significantly lower than that of the SWL group in patients with ≥10 mm stones (p=0.032).

Conclusions: Overall treatment outcomes and patient satisfaction were not significantly different between SWL and URS. However, patients undergoing URS for ≥10 mm proximal ureteral stones had lesser satisfaction with stone-free status, because of relatively lower stone-free rates due to upward stone migration. We suggest that factors regarding the subjective satisfaction of patients be included in counseling about treatment options for proximal ureteral stones.

Keywords: Lithotripsy; Patient satisfaction; Ureteral calculi; Ureteroscopy.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

FIG. 1
FIG. 1
Overall satisfaction according to treatment method. SWL: shock wave lithotripsy, URS: ureteroscopic removal of stone.
FIG. 2
FIG. 2
Overall satisfaction in patients with <10 mm (A) and ≥10 mm proximal ureteral stones (B). SWL: shock wave lithotripsy, URS: ureteroscopic removal of stone.
See this image and copyright information in PMC

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