Comparative Study of in Situ Eswl vs Push Back, Stenting and Eswl for Non Obstructing Upper Ureteric Stone

Abstract

Background : This is a hospital based prospective, cross sectional and interventional case control study conducted in department of urology, Chittagong Medical College, Bangladesh. Materials and methods : Total 120 patient of upper ureteric stone were included in this study divided by Group-A (60) and Group-B (60). Group-A 60 patient under went in situ ESWL and group-B 60 patient under went push back, DJ stenting and ESWL. Number of Shock wave session, energy used (KV) stone clearance, complications of ESWL like loin pain, haematuria, fever and Lower Urinary Tract Symptom (LUTS) and cost were compared between the two groups were recorded and analyzed. Results : In Group A total stone clearance were 96.7% (58/60) and group-B were 98.3% (59/60). But it was not statistically significant (p=0.559). Mean hospital stay of in situ group (Group A) was 1.03 ± 0.181 days compared to 2.57 ± 0.722 day in push back ESWL group (Group B). It was statistically highly significant (p=0.000). In group-A there was loin pain in 20 (33.33%). Haematuria 12(20%), fever in 06 (10%) and LUTS in 16 (26.7%) patients. In group B loin pain was in 35 (58.3%) (p-0.006). Haematuria 26(4.33%) (p=0.06), fever 14 (23.7%) (p=0.05) LUTS was 30 (50%) (p=0.009). More energy of ESWL (Kilo Volt-KV) required in group A than in group B. But is was not statistically significant (p=0.190). Conclusion : Complications between the groups were statistically highly significant. In situ ESWL is very good option for the management of upper ureteric stone. It is non-invasive, effective, safe, cost savings, less hospital stay and usually does not need anaesthesia.

JCMCTA 2017 ; 28 (1) : 57 - 62