title: Emergency management of ureteral stones: Evaluation of two different approaches with an emphasis on patients' life quality.
abstract: OBJECTIVE
  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 &lt; 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.
authors.affiliation: Dr. Lütfi Kirdar Training and Research Hospital Urology Clinic, Istanbul. saricakemal@gmail.com.
authors.forename: Kemal
authors.initials: K
authors.lastname: Sarica
authors.forename: Bilal
authors.initials: B
authors.lastname: Eryildirim
authors.forename: Cahit
authors.initials: C
authors.lastname: Sahin
authors.forename: Özlem Kolçak
authors.initials: ÖK
authors.lastname: Türkoğlu
authors.forename: Murat
authors.initials: M
authors.lastname: Tuncer
authors.forename: Alper
authors.initials: A
authors.lastname: Coskun
authors.forename: Hakan
authors.initials: H
authors.lastname: Akdere
mesh_terms: D059787:Acute Pain / Q000188:drug therapy / Q000209:etiology; D000328:Adult; D000700:Analgesics / Q000008:administration & dosage; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D011788:Quality of Life; D056844:Renal Colic / Q000628:therapy; D014514:Ureteral Calculi / Q000473:pathology / Q000628:therapy*; D014517:Ureteral Obstruction / Q000209:etiology / Q000628:therapy*; D018666:Ureteroscopy / Q000379:methods*
chemical_list: D000700:Analgesics