title: Ultrasonography-guided PNL in comparison with laparoscopic ureterolithotomy in the management of large proximal ureteral stone.
abstract: OBJECTIVE
  The aim of study was to evaluate the clinical outcomes of PNL in comparison with laparoscopic ureterolithotomy (LUL) in proximal ureteral stones larger than 1 cm.
  
  
  METHODS
  A total of 80 patients who were candidates for treatment of large ureteral stones in our urology center were enrolled in the study between September 2004 and September 2008. By using patient randomization, they were assigned into two forty-patient groups (PNL and LUL). After evaluating the patients with laboratory tests and IVP, PNL was performed under sonography guidance in the prone position or the patients were submitted to classic laparoscopic ureterolithotomy (LUL) transperitoneally. All patients underwent postoperative assessments including KUB and ultrasonography.
  
  
  RESULTS
  A hundred-percent success was achieved in both groups. The mean age of the patients were 39.4 (16-63) and 35.2 (18-57) years old in PNL and LUL groups, respectively. The mean stone size in PNL group was 14.2 (10-25) mm and in LUL group was 13.5 (10-28) mm. The duration of the operations were 54.35 (50-82) minutes, and 82.15 (73-180) minutes (P < 0.0001); and the average hospital stay days were 2.6 (2-5) and 3.5 (3-8) days (p = 0.011) in groups PNL and LUL, accordingly. The mean Hb decrease in PNL group was 0.9mg/dL and in LUL group was 0.4mg/dL (p = 0.001). No statistically significant differences in terms of blood transfusion, fever, ICU admission, and prolonged urinary leakage were detected in both groups.
  
  
  CONCLUSIONS
  According to our study, percutaneous nephrolithotomy under ultrasonography guidance is comparable with the laparoscopic ureterolithotomy for the treatment of proximal ureteral stones larger than 1 cm.
authors.affiliation: Urology and Nephrology Research Center UNRC, Shohada Medical Center, Shahid Beheshti University, M C SBMU, Tehran, I R Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Karami
authors.forename: Mohammad Mohsen
authors.initials: MM
authors.lastname: Mazloomfard
authors.forename: Behzad
authors.initials: B
authors.lastname: Lotfi
authors.forename: Asghar
authors.initials: A
authors.lastname: Alizadeh
authors.forename: Babak
authors.initials: B
authors.lastname: Javanmard
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D061646:Operative Time; D059035:Perioperative Period; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods; D014513:Ureter / Q000000981:diagnostic imaging / Q000601:surgery; D014514:Ureteral Calculi / Q000000981:diagnostic imaging* / Q000601:surgery*; D055815:Young Adult