title: [Effectiveness of flexible ureteroscopy versus extracorporeal shock wave lithotripsy for kidney stones treatment].
abstract: Primary endpoint was to objective a better effectiveness of flexible ureteroscopy (fURS) compared to extracorporeal shock wave lithotripsy (ESWL) 3 months after treatment of a unique kidney stone from 5 to 20mm. Secondary endpoints were to evaluate effectiveness in subgroup and tolerance. We conducted a prospective comparative randomised trial between May 2012 and February 2014. A computerised tomography was done before treatment and another 3 months after treatment. Of the 30 randomised patients, 8 dropped out from the study and 4 were lost to follow-up. Median time of follow-up was 3.82 months. In per-protocol analysis, success rate was 60% for fURS group versus 28.6% for ESWL group (P=0.29). In intention to treat analysis, success rate was 77.8% in fURS group versus 53.8% in ESWL group (P=0.38). In ESWL group, 5 patients (41.7%) needed a second treatment versus none in fURS group but it was not significant. During follow-up, 1 patient in each group presented a complication. Results of this feasibility study did not allowed to conclude on superiority of a technic. A multicenter study with more important enrollment is necessary considering economic side and tolerance of these treatments.
authors: Service d'urologie et de chirurgie de la transplantation, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France. Electronic address: emmanuel.ravier@chu-lyon.fr.
authors: E
authors: E
authors: Ravier
authors: Service d'urologie et de chirurgie de la transplantation, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France.
authors: N
authors: N
authors: Abid
authors: Service d'urologie, centre hospitalier Lyon-Sud, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France.
authors: A
authors: A
authors: Ruffion
authors: Service d'urologie et de chirurgie de la transplantation, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France.
authors: H
authors: H
authors: Fassi-Fehri
authors: Pôle d'information médical, d'évaluation en santé et recherche clinique, hospices civils de Lyon, 162, avenue Lacassagne, 69003 Lyon, France.
authors: C
authors: C
authors: Buron
authors: Pôle d'information médical, d'évaluation en santé et recherche clinique, hospices civils de Lyon, 162, avenue Lacassagne, 69003 Lyon, France.
authors: C
authors: C
authors: Ganne
authors: Unité de recherche clinique, hôpital de la Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors: A
authors: A
authors: Mallet
authors: Service d'urologie et de chirurgie de la transplantation, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France.
authors: X
authors: X
authors: Martin
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D008096:Lithotripsy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018666:Ureteroscopy / Q000295:instrumentation / Q000379:methods
keywords: Extracorporeal shock wave lithotripsy; Flexible ureteroscopy; Kidney stones; Lithiase; Lithotritie extracorporelle; Urologie; Urology; Urétéroscopie souple