title: Flexible Ureterorenoscopy versus Extracorporeal Shock Wave Lithotripsy for the treatment of upper/middle calyx kidney stones of 10-20 mm: a retrospective analysis of 174 patients.
abstract: To compare the outcomes of flexible ureterorenoscopy (F-URS) with extracorporeal shock wave lithotripsy (ESWL) for the treatment of upper or mid calyx kidney stones of 10 to 20 mm. A total of 174 patients with radioopaque solitary upper or mid calyx stones who underwent ESWL or F-URS with holmium:YAG laser were enrolled in this study. Each group treated with ESWL and F-URS for upper or mid calyx kidney stones were retrospectively compared in terms of retreatment and stone free rates, and complications. 87% (n = 94) of patients who underwent ESWL therapy was stone free at the end of 3rd month. This rate was 92% (n = 61) for patients of F-URS group (p = 0.270 p > 0.05). Retreatment was required in 12.9% of patients (n = 14) who underwent ESWL and these patients were referred to F-URS procedure after 3rd month radiologic investigations. The retreatment rate of cases who were operated with F-URS was 7.5% (n = 5) (p = 0.270 p > 0.05). Ureteral perforation (Clavien grade 3B) was occured in 3 patients (4.5%) who underwent F-URS. Fever (Clavien grade 1) was noted in 7 and 5 patients from ESWL and F-URS group, respectively (6.4% vs 7.5%) (p = 0.78 p > 0.05). F-URS and ESWL have similar outcomes for the treatment of upper or mid calyx renal stones of 10-20 mm. ESWL has the superiority of minimal invasiveness and avoiding of general anethesia. F-URS should be kept as the second teratment alternative for patients with upper or mid caliceal stones of 10-20 mm and reserved for cases with failure in ESWL.
authors.affiliation: Department of Urology, Kafkas University Faculty of Medicine, Kars, Turkey.
authors.forename: Kursat
authors.initials: K
authors.lastname: Cecen
authors.affiliation: Department of Urology, Kafkas University Faculty of Medicine, Kars, Turkey.
authors.forename: Mert Ali
authors.initials: MA
authors.lastname: Karadag
authors.affiliation: Department of Urology, Kafkas University Faculty of Medicine, Kars, Turkey.
authors.forename: Aslan
authors.initials: A
authors.lastname: Demir
authors.affiliation: Department of Urology, Kafkas University Faculty of Medicine, Kars, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Bagcioglu
authors.affiliation: Department of Urology, Kafkas University Faculty of Medicine, Kars, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Kocaaslan
authors.affiliation: Department of Urology, Acibadem University Faculty of Medicine, Kayseri, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Sofikerim
keywords: Flexible ureterorenoscopy; Mid calyx stones; Shock wave lithotripsy; Upper calyx stones