Emergency management of ureteral stones: Evaluation of two different approaches with an emphasis on patients’ life quality


Submitted: June 7, 2016
Accepted: July 19, 2016
Published: October 5, 2016
Abstract Views: 2091
PDF: 1489
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Authors

  • Kemal Sarica Dr. Lütfi Kirdar Training and Research Hospital Urology Clinic, Istanbul, Turkey.
  • Bilal Eryildirim Dr. Lutfi Kirdar Training and Research Hospital Urology Clinic, Istanbul, Turkey.
  • Cahit Sahin Dr. Lutfi Kirdar Training and Research Hospital Urology Clinic, Istanbul, Turkey.
  • Özlem Kolçak Türkoğlu Dr. Lütfi Kirdar Training and Research Hospital Radiology Clinic, Istanbul, Turkey.
  • Murat Tuncer Dr. Lutfi Kirdar Training and Research Hospital Urology Clinic, Istanbul, Turkey.
  • Alper Coskun Dr. Lutfi Kirdar Training and Research Hospital Urology Clinic, Istanbul, Turkey.
  • Hakan Akdere Trakya University, Faculty of Medicine, Urology Clinic, Edirne, Turkey.
Objectives: To evaluate the emergency management of obstructing ureteral calculi with two different techniques (SWL and URS) with an emphasis on patients life quality. Methods: A total of 80 patients presenting with acute colic pain due to a single obstructing ureteral stone were treated within 24 hours following the onset of pain with two different approaches in a randomized manner. Patients requiring DJ stent placement and/or auxiliary measures after both procedures were excluded and the remaining 65 patients were evaluated [Group1: ESWL (n = 34); Group 2: URS (n = 31)]. Patients were followed during 4-weeks period with respect to the analgesic requirement, number of renal colic attacks and emergency department visits along with the HRQOL scores. Results: While 26 patients treated with URS (83.9%) were stone-free, 24 cases in SWL were stone-free (70.6%) after 4 weeks. Evaluation of the cases during this follow-up period demonstrated that cases undergoing SWL required significantly higher amount of analgesics when compared with URS group (p < 0.001). In addition to the lower mean number of renal colic attacks and emergency department visits in URS group; both the mean HRQOL in terms of EQ-5D index and mean EQ-5D VAS values were also significantly higher in these cases when compared with the cases tretaed with SWL. Conclusions: Due to the negative impact of stone related events after emergency SWL on patients HRQOL, emergency URS may be applied more effectively with the advantages of prompt fragmentation of the calculi along with the immediate relief of obstruction and pain.

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Sarica, K., Eryildirim, B., Sahin, C., Türkoğlu, Özlem K., Tuncer, M., Coskun, A., & Akdere, H. (2016). Emergency management of ureteral stones: Evaluation of two different approaches with an emphasis on patients’ life quality. Archivio Italiano Di Urologia E Andrologia, 88(3), 201–205. https://doi.org/10.4081/aiua.2016.3.201

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